Nassau

Published on: August 12, 2012

Organization when it comes to head injury may actually save a great many lives worldwide

by Stephen Bilkis

Organization when it comes to head injury may actually save a great many lives worldwide, according to studies. Improving the intensive care and pharmacological treatments in areas that already have the best treatment is not enough. Different avenues need to be pursued when it comes to head injuries so people can be treated away from the hospitals and the best facilities as quickly and correctly as possible.

Reporters in Nassau and Suffolk have known this for years and certain physicians have worked to act upon it. A group of British neurosurgeons have created guidelines for head injury management which has already been adopted throughout the UK, as well as some other places in the world. Some of these guidelines focus on children and they are constantly being updated. These guidelines have increased the number of hematomas detected in the areas that utilize them.

These guidelines are best applied in cities, towns, and rural areas that do not have access to local 24-hour CT scanning facilities for all head injuries. The guidelines can detect certain traumatic brain injuries and those who are determined to be at risk than then be sent to the appropriate facility where 24-hour scanning is available. Without this preliminary examination, some may develop brain injuries later on that could result in serious consequences and complications, doctors have learned. Following guidelines to discover the signs for brain injury may well save many lives, and even lead to ways to prevent lingering injury or symptoms in the long run.

Published on: July 30, 2012

Non-impact generally means the head did not suffer a direct impact

by Stephen Bilkis

Many experiments have been done to determine if brain injury could occur without actual head impact, according to studies. An impact injury that deforms the skull may have some sort of mitigating factor because the skull distributes some of the force that would have otherwise been transferred directly to the brain, similar to the way a motorcycle helmet protects the head of the motorcyclist.

Non-impact generally means the head did not suffer a direct impact. The distinction is important to both forensic physicians and brain doctors. There have been a number of child abuse cases where the defense alleged brain damage was caused to infants by being shaken, rather than being struck by, or against, an object. Some studies have shown that shaking the torso of an infant was unlikely to harm the brain of the child, apart from a blow to the head. This is consistent with research from car crashes, which shows that force that comes from the torso to the head is unlikely to cause harm, even with the much greater force involved in a car crash.

Mathematical models in Nassau and Suffolk have been used to simulate the human body, in order to show how likely it was for injury to occur with differing impacts in a car crash. They tend to conclude that acceleration of the head is unlikely to reach a level that could cause brain injury, studies have learned. In a previous study of 400 fatally injured road users, there were no cases of brain injury without head impact.

Published on: July 14, 2012

Reducing the Occurrence of Traumatic Brain Injury in the Military

by Stephen Bilkis

Researchers recently found that soldiers who wear military helmets one size larger and with thicker pads, have reduced the severity of blunt and ballistic impact traumatic brain injury (TBI).

The one-year study funded by the U.S. Army and the Joint IED Defeat Organization (JIEDDO) was aimed at comparing the effectiveness of various military and football helmet pads.

The particular research facility used was chosen via a review committee. The committee concluded that the LLNL research lab had the best set of skills, and their previous experience working on blast-induced TBI would prove valuable.

Published on: June 17, 2012

Brain Injury Patients Testing New Treatments

by Stephen Bilkis

A new approach to treating brain injury patients is being tested by local military doctors.

A nationwide study is underway to see if the drug progesterone can help save lives and reduce disability in sufferers of head trauma.

Traumatic brain injuries (TBI) are the signature wounds of modern wars. But damage to the brain caused by an outside blow to the head also affects thousands of civilians each year, too, primarily in falls and car accidents.

Published on: May 24, 2012

Penetrative TBI involves the penetration of a foreign object through the bones of the skull

by Stephen Bilkis

Doctors have learned of a new classification for traumatic brain injury (TBI), known as explosive blast traumatic brain injury (bTBI). Previously, physicians divided TBI into two categories, penetrating traumatic brain injury (pTBI) and closed head traumatic brain injury (cTBI). Blast TBI is similar, but has some aspects that are all its own.

Penetrative TBI involves the penetration of a foreign object through the bones of the skull and into the brain parenchyma. This physically disrupts neurons, glia, and fiber tracts, which is made worse by ischemia and hemorrhage. Victims of this type of injury show signs of impaired consciousness and neurological difficulties associated with the parenchyma injured by the intrusion of the foreign object. An object penetrating at high velocity, like a bullet, will cause a great deal more damage, due to cavitation of brain tissue. There will be a breach in the skull where the object entered, and possibly another at the point of exit. pTBI is often easy to spot.

Closed head traumatic brain injury is sometimes more difficult to spot. The brain moving inside the skull and deformation of the brain can cause injury to the brain parenchyma, blood vessels, and fiber tracts.

Published on: May 23, 2012

Prevention of an injury is always better than curing one that’s already occurred

by Stephen Bilkis

Prevention of an injury is always better than curing one that’s already occurred. Doctors believe that it is an important part of public policy to educate people on ways to remain safe, in both developed and developing countries. Such programs require a national effort, building community awareness, and policies that promote both political and public education in order to reduce the number of injuries from occurring.

Such a program was undertaken by the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) in the mid-1980s, called the ‘Think First Prevention Program’. Its goal was to alter risky behavior with a study course aimed at youth. It reinforced public education methods and also sought to influence government policy. Neurosurgeons and lay members would give lectures, show videos, and even made a film called ‘Harm’s Way’.

The most common means of sustaining a head injury remains transport-related accidents, according to studies. Thus, the main focus of such educational efforts focuses on changing the environment in which the motorist, pedal cyclist, motorcyclist, or pedestrian operates. Public awareness programs can be used to both raise public awareness or to insist upon better public safety standards. Such policies have shown success in car advertisement, for example. Car safety as become as big, or a bigger, selling point for cars than the capacity for speed or power. Airbags and reinforced passenger capsules are options that are now standard in most vehicle models whenever possible. Hospitals in Nassau and Suffolk are aware of these situations.

Published on: May 13, 2012

The ongoing Global War on Terror has resulted in an increase of traumatic brain injury, or TBI

by Stephen Bilkis

The ongoing Global War on Terror has resulted in an increase of traumatic brain injury, or TBI, doctors have noted. A number of them suffer from an explosive blast (bTBI). Physicians have decided this type of injury is distinct from other forms of brain trauma, such as penetrating TBI (pTBI) and closed head TBI (cTBI).

Explosive blast causes more than 60% of combat casualties in the two current major American campaigns, Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom, according to studies. The main source of danger are the much talked-about IEDs – improvised explosive devices. The head is often injured in battle, accounting for 20% of all combat-related injuries in modern wars. When it comes to the wars in Iraq and Afghanistan, the data is still coming in. So far, the data seems to closely match that of previous wars.

Operation Iraqi Freedom and Operation Enduring Freedom are distinct from 20th century wars in the higher survival rate of those who are injured in combat, even those who suffer from TBI, according to studies. An important factor to be considered is the use of body armor. Doctors in Nassau and Suffolk used to believe that the severity of bTBI was due to pTBI from fragments of the explosive device or cTBI from the head striking an object after the victim was thrown.

Published on: April 30, 2012

Information collection is an important component of dealing with head injuries

by Stephen Bilkis

Information collection is an important component of dealing with head injuries. The use of registry systems for head injuries will allow medical professionals to track patterns of injury and learn better methods of preventing them. The lack of proper pre-hospital care can mean the difference between life and death. Most developed countries today, however, are adequately prepared to care for and transport patients when a head injury has occurred.

Pre-hospital care is another thing to consider when it comes to head injuries, according to doctors. Modern trauma care systems have refined resuscitation, triage, evacuation and primary and secondary care for the patient with severe or multiple injuries so that more lives are being saved than ever before. The system is regionalized in order to provide the best possible care, depending upon the specific circumstance. Regional Resource Trauma Centers provide education and research programs, as well as all levels of care. Community Trauma Centers provide care, but not education or research. Rural Trauma Hospitals in Nassau, Long Island may have limited resources, but they are able to stabilize then transfer patients to another facility.

Head injuries are a component in the vast majority of fatalities due to trauma. The involvement of neurosurgeons and systems of care reduce these fatalities dramatically, according to doctors. Minimal standards for the treatment of severe neurological injury have been suggested and even implemented in many places. Underfunding and difficulty in recruiting medical professionals to trauma care remains a problem, however.

Published on: April 28, 2012

When it comes to injury of any kind, including head injury, classification of severity is important

by Stephen Bilkis

When it comes to injury of any kind, including head injury, classification of severity is important. The first AIS (Abbreviated Injury Scale) was published in 1971, propelled by the American Medical Association, the Association for the Advancement of Automotive Medicine, and the Society of Automotive Engineers. It was originally created to assess impact injuries, but it has been revised a number of times since then.

The scale uses numbers to rank injuries by severity, based upon the anatomical injury. This means that any lingering consequences of the injury, like disabilities, are not noted. Each injury only receives one AIS score, and there is no single assessment for multiple injuries.

The system has a 6-point scale, with 1 meaning a minor injury and 6 being the worst possible injury. Later revisions included a six-digit code for each injury. The first number signified body region, the second anatomic structure, the third and fourth the specific nature of an injury if external, and the fifth and sixth related to the level of injury in an anatomic region. Later revisions included further categorization for brain injuries.

Published on: March 29, 2012

Things become much more complex in a non-free field or enclosed area, such as a building, experts have learned.

by Stephen Bilkis

The type of explosion studied theoretically in the determination of the causes of explosive blast traumatic brain injury (bTBI) assumed an open field explosion. Things become much more complex in a non-free field or enclosed area, such as a building, experts have learned. Concussions are common place.

In an enclosed space, the shockwaves can reflect from walls, ceilings, and other objects, creating a “complex wave field.” An explosive blast under such conditions creates an individual scenario that cannot accurately be predicted or replicated.

Doctors in Nassau and Suffolk Counties have noted there has been the assumption that pressure, and not the shockwave, may cause bTBI, but such studies may not be valid. These studies suggest the pressure of the blast leads to failure of air-filled organs, such as the lungs and the bowels. Therefore, if this is true, lungs should be injured more often in explosions. Clinical experience shows this is not the case. The bowel is generally uninjured unless there is penetration from shrapnel. Brain injurywas not studied and some believe interceptor body armor may protect those organs from the blast. There may even be other physical forces that play a role in explosive blast injury.