BRAIN AND SPINAL RESEARCH

BRAIN INJURY - WHAT DOES IT MEAN?

2011-11-28T18:26:00.000-08:00

Brain Injury: What Does it Mean?

NOVEMBER 15, 2011

tags: health, brain, dementia, prevention, brain injury, gabby giffords, sports, football, war, surgery, helmets, chronic traumatic encephalopathy, dementia pugilistica, herniation, decompressive craniectomy, cranioplasty

From war injuries to football, to the plight and recovery of Congresswoman Gabby Giffords, brain injury has become one of the most-discussed topics in health care today. Brain injury encompasses a very large spectrum of possible problems with a variety of causes and potential outcomes.

What happens when the brain is injured?

This depends on a few factors:

1. Location

2. Type of injury

3. Extent of the injury

4. Age

The location of the injury can determine how the brain reacts. Generally, if you were to, say, bang your knee into the side of your desk, or accidentally skin it while biking, you will notice that a little swelling and bruising develops soon after. The same kind of process happens when the brain is injured. While your knee can handle a little swelling, your brain doesn’t react as well.

Here’s why:

(Source: http://www.bcs.org/content/conWebDoc/15499)

Your brain sits in your cranium, protected by the skull, and cushioned by cerebrospinal fluid (CSF). Given that the cranium is a bony chamber with no flexibility, if the brain were to swell, it increases intracranial pressure. The increased pressure puts added stress on the already injured brain, causing further complications and potentially death.

Increased pressure in any system generally needs an outlet, a means of reducing pressure. If you think of moving tectonic plates, increased pressure in between two plates is released when they shift. Similarly, increased pressure within the brain can cause structures to shift if the pressure is high enough. This is called herniation. Depending on where the herniation occurs, the consequences can be devastating, especially if the brain is injured in or herniates into a location occupied by structures that are instrumental for basic processes such as respiration and heartbeat.

The type of injury, as well as its extent, can also determine what happens. Blunt force trauma can affect a larger swath of brain tissue, compared to, say, a gunshot (depending on its trajectory). In the case of Gabby Giffords, the fact that bullet remained in the left hemisphere, rather than crossing hemispheres, or entering any higher or lower made a difference in her outcome. Repeated injury can also further potentiate damage, as is the case with repeated concussions seen in football players.

Age can play a very key role in how the brain both reacts immediately following injury, as well as in the recovery period. The younger the patient is, the better the outcome, generally speaking. The benefit of being younger is that the skull bones have not fused completely, and there are intervening sections of flexible tissue known as fontanels. These exist for the sake of allowing the brain to grow, as would be expected in a growing child. In the setting of brain injury, though, the fontanels allow the brain to expand and thus relieve some of the pressure. Given that the brain is still fairly plastic, and able to more readily form new connections in response to the environment, recovery from brain injury can be more rapid. This isn’t to say older patients are not as likely to recover, because sometimes with enough stimulation and therapy, recovery can be possible.

It’s important to respond to symptoms quickly. In the case of Gabby Giffords, the cause and relative extent and severity of the injury was known immediately, and care was provided rapidly. However, what if you bang your head hard against a surface? Sometimes it the severity is not known, and symptoms can be written off as less severe than they really are. The case of Natasha Richardson, the wife of Liam Neeson, comes to mind. She fell while skiing, and though was fine at the time, developed severe headaches later on. By the time help came, it was too late. Onset of severe headaches, disorientation, confusion, movement difficulties, among others, should not be ignored. These can be signs of increased intracranial pressure resulting from brain injury.

Treatment options are varied. Attaching the patient to a ventilator to blow off extra carbon dioxide is one method of relieving some of the pressure. A decompressive craniectomy is another option, and involves moving part of the skull to allow the brain to swell. The bone flap is later put back during a procedure known as cranioplasty. Physical therapy, occupational therapy, speech therapy, and other interventions can help to rebuild connections lost as a result of injury.

Again, as someone very interested in public health, my mantra is prevention, prevention, prevention. How do we prevent brain injuries? Safety is key. Wear helmets when engaging in sports that call for it. Wear your seat belt in the car. Football especially has become strongly associated with a risk for brain injury, and later risk of dementia pugilistica/CTE (a term that originally was coined due to the frequency seen in boxers). Rest is essential for recovery, whether in mild or more severe cases. The go-go-go mentality whether injured or not is absolutely the wrong approach for a player who has sustained a concussion in a sports setting, or for any person who has had a brain injury of any sort. As much as I love football, I would even go so far as to say that children should avoid playing the sport, given that the cumulative effects of all those hard hits and tackles could result in irreversible brain injury and dementia down the road. Too many football players have either died from or been diagnosed with the early stages of this condition. Until effective safety measures and new means of preventing injury are in place, it is probably not even worth taking the risk.

USB - GEMASSIST

2011-11-19T17:20:00.000-08:00

Quote from "Heathcare with USB"

USB benefits

The most common and widely used wired protocol to communicate between the data acquisition devices and the hub is USB. The main reason USB has become so prevalent is that it is the first of the wired communication protocols to become a standard, a consortium consisting of more than 200 member companies from the technology and the medical device markets. This is establishing a system of connected personal telehealth solutions that fosters independence, empowers people and organisations to better manage health and wellness while offering personalised health and wellness management solutions.

gemassist final.mp4

2011-11-01T19:49:00.000-07:00

DEMENTIA QUOTES FROM Tom Schweizer, a neuroscientist.

2011-10-15T16:46:00.000-07:00

You may have heard it before: being bilingual can help ward off dementia. Now, a new study offers the brain scans to back up those findings.
A number of studies in recent years have shown that knowing more than one language and speaking them regularly can delay the onset of dementia. Those studies reached their conclusions by looking at bilingual and monolingual seniors and then noting the age at which the patients began to decline cognitively with memory problems, attention problems and difficulty with planning and organization.
This new study from Toronto researchers included CT (computed tomography) brain scans of patients who had been diagnosed with probable Alzheimer's disease and who had similar levels of education and cognitive skills.
The team found that the scans of the bilingual patients showed twice as much damage in areas of the brain known to be affected by Alzheimer's. And yet, cognitively, these patients were doing as well as their monolingual counterparts.
The finding suggests that being bilingual somehow preserves cognitive function, even with areas of the brain being destroyed by disease, says Dr. Tom Schweizer, a neuroscientist at St. Michael's Hospital who led the study.
"What we noticed was that in the areas associated with Alzheimer's pathology -- so that's the temporal cortex, which is the area of the brain that serves memory function -- we noticed that the bilingual patients had twice as much atrophy in those areas than the monolingual patients," Schweizer explained to CTV's Canada AM.
"That's interesting because, despite the extra disease burden in the bilingual patients, they maintained their level of cognitive performance as well as monolingual patients."
The study, which appears in the journal Cortex, was small, involving just 40 patients, half of whom were fluent in another language. But it's being called the first to provide physical evidence to confirm the previous research on the topic.
While it should stand to reason that brains that look more damaged would perform worse on thinking tests, Schweizer theorizes that being bilingual somehow protects the brain, boosting its "cognitive reserve" and resilience to damage.
It's still unclear how being bilingual protects the brain. Schweizer says it could be that bilingual people who are constantly switching from one language to another are exercising their brain without even realizing it.
"We think it's enhancing neural networks in the brain; it's actually making the brain a little more efficient and so it can probably compensate for any type of disease process," he explained.

St. Michael's Hospital appears on Canada AM, Friday, Oct. 14, 2011:

The study authors say that while being bilingual might delay the onset of dementia symptoms, bilingualism can't prevent dementia.
But they say more study is needed to determine whether, once dementia symptoms appear, the disease progresses faster in bilingual people than monolingual patients.
They'd also like to know whether a second language has to be learned early in life to provide the most benefit.
The team would like to repeat the study in a larger sample of patients, using more sophisticated MRIs, which do a better job of noting brain damage.
The concept that one can build up "cognitive reserve" is one of the reason that why many physicians encourage older people to do brain work, like crossword or Sudoku puzzles, says Schweizer.
"You may not want to pick up another language; you may want to learn a musical instrument -- anything to exercise the brain and keep it active in your retirement years, and hopefully before that so you can keep that ball rolling."

2011-09-30T21:23:00.000-07:00

This brain plasticity is amazing as I am experiencing it myself. It does not cure you but I will quote from "PostitScience";

The Plasticity Revolution
The growing understanding of and interest in brain plasticity is driving a revolution in brain health and science. In addition to the work being done at Posit Science, scientists at institutions around the globe are beginning to look to plasticity-based therapies for treating a wide spectrum of other cognitive problems. Ultimately, brain-plasticity based programs might help schizophrenics improve their symptoms and live more normal lives. Musicians stricken with focal dystonia might learn to play again, without pain. People with mild cognitive impairment or early-stage Alzheimer's might halt the progression of their disease. Cancer patients whose ability to function has been impeded by the lasting cognitive effects of chemotherapy treatment might find their old selves again. Stroke or traumatic brain injury victims may relearn skills they thought were lost forever and the list goes on.

MIGRAINES AND TIA

2011-09-28T22:13:00.000-07:00

Clinical Features of Late-Life Migraine Versus TIAs
• Gradual appearance of focal neurologic symptoms with spread
or worsening over a period of minutes
• Headache present in 50% of cases
• Positive visual symptoms, such as scintillating scotoma or flashing
or bright lights
• Serial progression from one accompaniment to another (for
example, from flashing lights to paresthesias, paresis, or dysphasia)
• Diagnosis facilitated with the occurrence of
• Duration of 15-25 minutes (as opposed to <15 minutes in 90% of
headaches associated with TIA)
• Characteristic “flurry” of accompaniments
• Usually benign natural history without permanent sequelae
• No other cause revealed by diagnostic testing performed
when indicated
≥2 identical episodesFisher CM. Late-life migraine accompaniments-further experience.

Quoted; Vol. 19 No. 11 ISSN 0264-6404 December 2001
21st Century Prevention and Management of Migraine Headaches
National Institutes of Health
Stroke. 986;17(5):

Alzheimer's Disease

2011-09-17T11:00:00.000-07:00

"People with poor vision who did not visit an ophthalmologist over an 8-to 1/2 year period had a much greater chance of developing dementia. Please use your calendar to schedule an appointment to have your eyes checked (at least once every two years)." by Dr. Brain K. Regan, Ph. D.

BRAIN AWARENESS: What is "Brain Awareness?"

2011-09-09T19:46:00.000-07:00

BRAIN AWARENESS: What is "Brain Awareness?": By: Dr. Pascale Michelon "Neuroplasticity The catchy phrase behind neuroplasticity is “neurons that fire together wire together”....

What is "Brain Awareness?"

2011-09-09T19:42:00.000-07:00

By: Dr. Pascale Michelon

"Neuroplasticity
The catchy phrase behind neuroplasticity is “neurons that fire together wire together”. The idea is that when two events (neurons firing) occur in the brain at the same time, the events (neurons) become associated with one another, and the neuronal connections (wiring) become stronger.
For many years, it was thought that each area of the brain had its own responsibilities; in other words, certain functions were localized or hardwired to certain brain areas. If something is hardwired then it is fixed and not capable of change."

Presently, the last 2 years, I have been experiencing this plasticity by the help of Shepherd Center, Friends, Family and my own research on brain plasticity or neuroplasticity. It is amazing "how you can assist your brain by doing just small everyday things."