Traumatic brain injuries (TBI) pose a significant public health danger, affecting millions of individuals annually. A TBI happens when rapid trauma harms the brain, and its severity can range from moderate to fatal.
Understanding the different types of TBI is essential for both prevention and treatment. There are three primary categories of TBI: concussions, contusions, and penetrating injuries. Each type presents unique risks and legal implications, particularly when negligence or intentional harm is involved.
1. Contusions
Contusions, or bruises to the brain, are one of the most common types of brain injuries. They happen when a direct blow to the head causes bleeding or edema in brain tissue. Contusions, unlike concussions, are typically more localized injuries that might result in more severe symptoms depending on the location of the brain affected.
Contusions are significant in personal injury and medical malpractice cases. For example, suppose a person suffers a contusion after slipping on an unmarked wet floor at a grocery store. In that case, they could pursue compensation for medical bills, lost wages, and emotional distress. The primary challenge in these instances is frequently demonstrating negligence, whether the property owner, employer, or another person failed to make reasonable efforts to avoid the injury.
(more…)
Motorcycle accidents are more dangerous than car accidents since the rider often feels the direct impact on the accident due to the lack of a protective metal covering.
While you might be wearing a helmet, the head protection it offers may not be sufficient to completely protect the head. This is particularly true when the motorcyclist is involved in severe accidents. In some instances, you might even end up suffering a brain injury despite wearing a helmet.
But how do brain injuries due to a motorcycle accident occur? Let’s explore the causes, types, and symptoms of brain injuries from motorcycle accidents.
(more…)
MedicalResearch.com Interview with:
Mireille E. Kelley Ph.D.Staff Consultant for Engineering Systems Inc.
MedicalResearch.com: What is the background for this study? Response: Youth and high school football players can sustain hundreds of head impacts in a season and while most of these impacts do not result in any signs or symptoms of concussion, there is concern that these repetitive subconcussive impacts may have a negative effect on the brain.
The results of this study are part of an NIH-funded study to understand the effects of subconcussive head impact exposure on imaging data collected at pre- and post-season time points. The present study leveraged the longitudinal data that was collected in the parent study to understand how head impact exposure changes among athletes from season to season and how that relates to changes measured from imaging.
(more…)
MedicalResearch.com Interview with:
Tara L Sharma DO
Clinical Assistant Professor of Neurology at UWMC
Seattle, WA 98133
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Flying can lead to reduced oxygen partial pressures and cerebral blood flow causing worsening clinical outcome in cases of moderate to severe TBI; however, not much is known regarding the clinical consequences of flying in individuals with concussion or mild TBI. Because many athletes suffer concussions during games, it is necessary to know if flying afterward may potentially hinder their ability to return to play.
Overall, we found no associated between air travel and increased symptom severity in both our entire cohort and the subset of football players.
(more…)
MedicalResearch.com Interview with:
Robert F. Heary, M.D.
Co-Director, Reynolds Family Spine Laboratory
Director, Spine Center of New Jersey
Professor, Rutgers New Jersey Medical School
Newark, New Jersey
MedicalResearch.com: What is the background for this study? Response: This article was written to assess the relative danger versus safety of youth football. As this is a hot-button topic in the world of neurosurgery and neurology, we decided to look into this issue.
In a suburban town, middle school football players were studied. They wore helmets with accelerometers mounted inside the hemet to measure how many hits the player absorbs and the magnitude of the force behind the hits. Also, soft “guardian caps” we worn over the outside of the helmets during practices.
For all football activities (practices and games), the helmets were worn and data were accumulated. In addition, specialized coaching related to safe tackling techniques was provided.
(more…)
MedicalResearch.com Interview with:Benjamin N. Breyer MD, MAS, FACS
Associate Professor
Departments of Urology and Epidemiology and Biostatistics
University of California, San Francisco
Vice-Chair of Urology
Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center
Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship
MedicalResearch.com: What is the background for this study? Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities.
(more…)
MedicalResearch.com Interview with:
Adnan Hirad, PhD
MD Candidate, Medical Scientist Training ProgramUniversity of Rochester
School of Medicine and DentistryMedicalResearch.com: What is the background for this study? Response: Concussion is defined based on the manifestation of observable signs and symptoms (e.g., dizziness, difficulty with concentration, loss of consciousness, inter alia). A non-concussive head injury is when someone hits their head but does not exhibit the signs and symptoms of concussion -- IE concussion is defined by observable signs, and sub-concussive is defined as sustaining head impacts similar (in magnitude and mechanism) to those sustained with concussion without observable signs and/or symptoms. These hits are a problem not only in football, but also with IED/bomb blasts experienced during war and potentially rugby.(more…)
MedicalResearch.com Interview with:
Sean C. Rose, MD
Pediatric sports neurologist and co-director of the
Complex Concussion Clinic
Nationwide Children’s HospitalMedicalResearch.com: What is the background for this study? What are the main findings?Response: Very limited data has been collected in children while they are playing contact sports to study the relationship between repetitive head impacts and neurocognitive outcomes. We previously published a 1-year analysis of youth tackle football players and found no association between the number or severity of head impacts and performance on neurocognitive testing before to after the football season. We are now reporting the results from the 2nd year of our study, tracking children through two seasons of football participation.
We measured head impacts using helmet sensors during the 2016 and 2017 football seasons. In the total group of 166 players age 9-18, one outcome measure (processing speed), out of the 23 outcome measures studied, declined over time. However, several other measures that also assessed processing speed did not decline. Neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance over the course of the two seasons.
(more…)
MedicalResearch.com Interview with:
Kelly Russell PhD
Department of Pediatrics and Child Health
University of Manitoba
MedicalResearch.com: What is the background for this study? Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life. HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion. Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician. We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery.
We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury. We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.
(more…)
MedicalResearch.com Interview with:
Robert Ross, Ph.D.
Assistant Professor
McConnell Hall, Room 424
University of New HampshireMedicalResearch.com: What is the background for this study? Response: In the United States, 1.5-2 million people suffer from mild traumatic brain injuries, more commonly referred to as concussions, per year.
There is a large body of work illustrating the cognitive impairments associated with concussions in the immediate aftermath of the concussive event. However, it is not clear whether concussions can change cognition more long-term and how concussions might change how the brain functions during specific types of cognition.
In our study, we examined executive function, which is a cognitive process that helps control or manage other cognitive functions, in a group of healthy young adults aged 18-24 that had suffered at least two concussions and compared their performance and their brain oscillations to a group that had not suffered any concussions. Brain oscillations help the brain coordinate the activity of the thousands of neurons necessary for any sort of cognitive process to occur. The participants in the study self-reported their concussions with all concussions occurring at least one month prior to participating in the experiment.
(more…)
MedicalResearch.com Interview with:
Jeffrey A. (Jeff) Russell, PhD, AT, FIADMS
Science and Health in Artistic Performance
Division of Athletic Training, School of Applied Health Sciences and Wellness
Ohio University
Athens, OH 45701
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Everyone knows that enormous attention is given to concussions in sports today. Those involved in performing arts experience many head impacts, too; yet, they receive neither the attention nor the specialized care for concussions that athletes do.
At Ohio University’s Clinic for Science and Health in Artistic Performance (SHAPe Clinic) that I direct, we were seeing a number of theater students suffer concussions. So, Brooke Daniell and I decided explore this trend more closely. This is the first known published research to evaluate the prevalence of head impacts in theater personnel. In the sample we studied, which comprised predominantly those involved in various aspects of theater production, the prevalence of receiving at least one head impact in a theater career was 67%. Of those who sustained at least one head impact from theater, 77% reported three or more head impacts, and 39% reported more than five impacts. More troubling, of those who said they had received a head impact that was accompanied by concussion-like symptoms, 70% indicated that they continued their work, and half of those did not report the incident to anyone.
(more…)
MedicalResearch.com Interview with:
Dr. Megan E. Narad, PhD
Division of Behavioral Medicine and Clinical Psychology
Cincinnati Children's Hospital Medical Center | CCHMC
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Previous research has shown that children with a history of traumatic brain injury (TBI) demonstrate difficulties with attention following injury; however, most studies only follow children 2-3 years after injury. Our study followed a group of children with a history of TBI 7-10 years after injury.
The main finding is that those with severe TBI were at greater risk for developing secondary attention deficit hyperactivity disorder (SADHD) than those with orthopedic injury; however, it should also be noted that kids with less severe injuries were also at risk of developing SADHD. In addition to injury severity, environmental factors (maternal education and family functioning) also played a role in SADHD development. It should also be noted that a number of kids developed SADHD >3.5 years after injury suggesting that these difficulties may not surface until many years after injury.
(more…)
MedicalResearch.com Interview with:Dr. Steven D. Hicks, M.D., Ph.D
Penn State Health
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Previous research has shown that small epigenetic molecules called microRNAs are altered in the blood after a traumatic brain injury. Our own pilot research showed that microRNAs were also changed in the saliva after brain injury and that some of these changes mirrored changes in cerebrospinal fluid. In this study we investigated whether salivary microRNA patterns after a concussion could be used to predict the duration and character of symptoms one month after injury.
We found that levels of five microRNAs predicted presence of symptoms one month later with greater accuracy (~85%) than standard surveys of symptom burden (~65%). Interestingly, one of the predictive salivary microRNAs (miR-320c) targets pathways involved in synaptic plasticity and was significantly correlated with attention difficulties one month after concussive injury. (more…)
MedicalResearch.com Interview with:
Jingzhen (Ginger) Yang, PhD, MPH
Principal Investigator
Associate Professor, Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Dept. of Pediatrics, College of Medicine, The Ohio State University
Columbus, Ohio 43205MedicalResearch.com: What is the background for this study?
Response: From 2009-2014, all 50 states and the District of Columbia passed their state TBI laws, more commonly known as concussion laws, to mitigate severe consequences of concussions.
These laws often include 3 core components:
(1) mandatory removal from play following actual or suspected concussions,
(2) requirements to receive clearance to return to play from a licensed health professional, and
(3) education of coaches, parents, and athletes regarding concussion symptoms and signs.
Our study aimed to evaluate whether the laws achieve the intended impact.
MedicalResearch.com: What are the main findings?
Response:The main findings showed that:
The rates of new and recurrent concussions initially increase significantly after a law goes into effect. This is likely due to more people – athletes, athletic trainers, coaches, and parents – becoming aware of the signs and symptoms of concussion and actually reporting a potential or actual concussion. Lack of knowledge about concussion signs and symptoms may have resulted in underreporting of concussions during the prelaw period. This trend is consistent across sports in our study and other studies looking at youth sports-related concussions.
The rate of recurrent concussions shows a significant decline approximately 2 ½ years after the law is in place. This demonstrates that the laws are having an impact. One of the core function of these laws is to reduce the immediate risk of health consequences caused by continued play with concussion or returning to play too soon without full recovery. The decline in recurrent concussion rates in our study is likely the results of the laws requirements of mandatory removal from play or permission requirements to return to play.
Football had the highest average annual concussion rate, followed by girls’ soccer and boys’ wrestling.Males had a higher average annual concussion rate than females. However,when comparing the rates in gender comparable sports (basketball, soccer, baseball/softball), females had almost double the annual rate of concussions as males. These results are consistent with findings from other studies. It is possible that girls have higher risk of concussions than boys or are more likely to report injuries. Future studies are needed to look specifically at these disparities.
MedicalResearch.com Interview with:Steven Daniel Hicks, MD, PhD
Assistant Professor, Division of Academic General Pediatrics
College of Medicine
Penn State Health
MedicalResearch.com: What is the background for this study? What are the main findings?Response: There are about 3 million concussions in the US each year and the majority occur in children. Parents of children with concussions commonly cite length of recovery as a major concern, but pediatricians have no objective or accurate tests for addressing this concern.
Our research group previously identified small regulatory molecules called microRNAs that were altered in both the spinal fluid and saliva in children with traumatic brain injuries. In this study we investigated whether those microRNAs could predict duration of concussion symptoms. In 52 children with concussion we found a set of microRNAs that predict whether concussion symptoms would last beyond one month with over 80% accuracy. This was significantly more accurate than survey based tools such as the sports concussion assessment tool or a modified concussion clinical risk score. Interestingly, the microRNAs with predictive accuracy targeted pathways involved in brain repair and showed correlations with specific concussion symptoms.
(more…)
MedicalResearch.com Interview with:
Dr. David W. Lawrence, MD
Department of Family & Community Medicine
St Michael's Hospital, University of Toronto
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Lawrence: The risk of all-cause injury and concussion for NFL athletes is significant. There has been a lot of discussion recently about this risk of injury in the NFL and general player safety, particularly regarding concussions. The first step in improving player safety and lowering that risk is to identify the factors affecting injury rates. Once we can answer those questions, we can begin to modify player exposure.
(more…)
MedicalResearch.com Interview with:
Roger Zemek, MD, FRCPC
Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa
Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario
Ottawa, ON
MedicalResearch.com: What is the background for this study?
Dr. Zemek: The number of concussions have dramatically increased over the past decade. Not only are children and adolescents are at highest risk for getting concussions, they also take longer to recover. As part of our background work, our team performed a systematic review (published in JAMA Pediatrics) confirming that validated, easy-to-use prognosticators did not exist for clinicians to identify children with concussion who are at the highest risk for persistent post-concussive symptoms (PPCS) and sequelae.
MedicalResearch.com: What are the main findings?
Dr. Zemek: In this, the largest concussion study in the world to-date, we derived and validated in a large, diverse cohort of children a clinical risk score that is significantly superior to clinicians’ ability to predict future PPCS at the time of ED presentation. Multivariate analysis revealed that age group, female sex, past history of migraine, prior concussion with symptom duration of >1 week, ED presentation with “answering questions slowly”, 4 or more errors on BESS Tandem stance, and the initial symptoms of headache, noise sensitivity and fatigue were all clinically significant and strongly associated with PCS at 1-month.
We assigned points based on the adjusted multivariate odds ratio, and the rule incorporating patient demographic factors, past history, early cognitive deficits, balance (an physical exam finding), and early symptoms. The rule has a maximum of 12 points. We selected two cut-off points in order to yield three clinically relevant (low, intermediate and high risk) categories for the development of PPCS at one month.
(more…)
MedicalResearch.com Interview with:
Grant L. Iverson, PhD
Director, Sports Concussion Program
MassGeneral Hospital for Children
Director, Neuropsychology Outcome Assessment Laboratory, Department of Physical...
MedicalResearch.com Interview with:
Pashtun Shahim, MD
Departement of Neurosurgery,
University Hospital, Linköping, Sweden
Clinical Neurochemistry Laboratory
Institute of Neuroscience and Physiology
Sahlgrenska University Hospital
Mölndal Sweden
Medical Research: What is the background for this study? What are the main findings?
Response: Visinin-like protein-1 (VLP-1 or VILIP-1) is a neuronal calcium-sensor protein, originally studied as a stroke marker and identified as a marker of neuronal injury in brain injury models. Increased plasma and cerebrospinal fluid (CSF) VILIP-1 hase been reported in Alzheimer’s disease, where CSF VILIP-1 correlates with CSF total tau (T-tau) and with brain volume. Recently, using a novel ultrasensitive method to measure tau in plasma, increased levels of plasma T-tau were found in concussed professional ice hockey players, where the levels correlated with the resolution of post-concussive symptoms and the players returning to play.
The main findings of this study were that VILIP-1 did not increase significantly in serum after sports-related concussion. However, the serum levels of VILIP-1 increased after a friendly game without concussion, signaling extracerebral expression.
(more…)
MedicalResearch.com Interview with:
Thomas P. Dompier, PhD, ATC
President and Injury Epidemiologist
Datalys Center for Sports Injury Research and Prevention, Inc
Indianapolis, IN 46202
Adjunct Faculty Appointments
Ohio University Rocky Mountain University of Health Professions
University of South Carolina
Medical Research: What is the background for this study?
D: Dompler: Per the Institute of Medicine’s recent recommendations to better describe the incidence of concussion in sport across the entire spectrum of youth sports (5-23 years), this study is the first to provide an apples-to-apples comparison using epidemiologic data provided by healthcare providers (athletic trainers) who attended all practices and games and used the same methodology to report concussions and student-athlete exposure information.
Medical Research: What are the main findings?D: Dompler:
a. The main findings are that the risk (how many players out of 100 can expect to suffer at least one concussion during the season) is lowest in the youth, and increases with age.
b. Game concussion rates (how many players out of 1000 exposed during a practice or game, includes multiple concussions to the same player) are highest in college but practice concussion rates are lowest in college during practice. This suggests more can be done during high school and youth practices to reduce concussion frequency (e.g. limiting how much time can be devoted to full contact, reducing player-to-player contact by teaching proper tackling without using full contact drills such as the Oklahoma drill and others).
c. While the rate is higher, there is still a substantial number of concussions that occur during practice (because there are more practices), therefore sports medicine staff should be available at both if possible (this is difficult at the youth level because of cost, however).
(more…)
MedicalResearch.com Interview with:
Dr. Pina Violano, RN, PhD
Trauma Department, Yale-New Haven Hospital,
Injury Free Coalition for Kids of New Haven
Yale-New Haven Children’s Hospital
New Haven 06510, CT
MedicalResearch: What is the background for this study? Dr. Violano: In July of 2012, Connecticut became one of the first states to enact legislation to ensure the safety and appropriate evaluation and management of sports-related concussions (SRC) among High School students. SRCs are a common occurrence in high school sports with their diagnosis increasing over the last decade. While the exact reasons are not known, public health campaign efforts and education may have facilitated improvement in the evaluation and detection of sports-related concussions and may have contributed to increase awareness and treatment.
MedicalResearch: What are the main findings?Dr. Violano: Evaluation of two emergency department records revealed a marked increase in the frequency of high school student athletes being treated for sports-related concussions after the implementation of Connecticut’s SRC law. This suggests that Connecticut’s legislation is effective in improving the evaluation and detection of sports-related concussions in high school students.
(more…)
MedicalResearch.com Interview with: James L . Spira, PhD, MPH, ABPP
Professor, Department of Psychiatry, John A Burns School of Medicine, University of Hawaii
Director, National Center for PTSD, Department of Veterans Affairs, Pacific Islands Division
Medical Research:What is the background for this study?Dr. Spira: Approximately 1.5 million Americans survive a traumatic brain injury (TBI) from traffic accidents, assaults, sports, and work injuries, with the vast majority of these being primarily mild (mTBI), otherwise known as concussion.1 Concussion, however, is uniquely problematic in the military given the new strategies of war encountered by service members when fighting an insurgency using improvised explosive devices. The rate of concussion experienced by United States (U.S.) service members engaging in combat during the wars in Afghanistan and Iraq has been estimated at between 15% and 22%.2–4There has been controversy in the area of neurotrauma as to whether persistent postconcussive symptoms (PPCSx) are due to neurological causes or solely due to the psychological sequelae of having been exposed to a traumatic event. The recent wars in Iraq and Afghanistan have afforded an opportunity to examine these factors, although teasing them apart has proven difficult. The most influential study of persistent effects of concussion in service members is that of Hoge and colleagues,5 in which they failed to find an independent effect of prior concussion on PPCSx, once depression and posttraumatic stress (PTSD) was taken into account. They went so far as to recommend that assessment for concussion following deployment is unnecessary. Others, however, have reported persistent cognitive, emotional, and physical symptoms following concussion.
(more…)
MedicalResearch.com Interview with: Anthony P. Kontos, Ph.D.
Assistant Research Director
UPMC Sports Medicine Concussion Program
Associate Professor
Department of Orthopaedic Surgery
University of Pittsburgh
Medical Research: What are the main findings of the study?Dr. Kontos: Our new Vestibular/Ocular Motor Screening (VOMS) examination was able to accurately identify nearly 90% of patients with a concussion. In our study of 64 concussed patients approximately five days post-injury and 78 healthy control-group patients who were administered VOMS by trained clinicians, we also found that more than 60% of patients with a concussion reported symptoms or had impairment on the VOMS following their injury. The VOMS, which was developed in conjunction with an interdisciplinary team of experts, assesses five areas of the vestibular ocular system: smooth pursuits, saccades (rapid eye movement), horizontal vestibular ocular reflex (VOR), visual motion sensitivity (VMS), and near-point-of-convergence (NPC) distance.
(more…)
MedicalResearch.com Interview with:Lara B. McKenzie, PhD MA
Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Columbus, OH 43205
Medical Research: What are the main findings of the study? Dr. McKenzie: Our main findings were that lacrosse injury rates and patterns are different by sex and by type of athletic activity. Boys’ lacrosse allows for some person-to-person contact, while girls’ lacrosse largely outlaws it. Boys had an overall injury rate of 2.26 per 1000 athletic exposures, and girls had an injury rate of 1.54 per 1000 athletic exposures. The overall injury rate was about 3 times higher in competition than in practice. We also found that sprains and strains were the most common injury diagnosis for boys and girls (boys: 35.6% of injuries; girls: 43.9%), but that concussions were a significant injury diagnosis (boys: 21.9% of injuries; girls: 22.7%).
(more…)
MedicalResearch.com Interview with:Stephanie F. Polites, MD
Department of Surgery and
Michael B. Ishitani, MD
Department of Pediatric Surgery
Mayo Clinic, Rochester, Minnesota
MedicalResearch: What are the main findings of the study?Answer: Though most injuries were in boys, 20% of the injuries occurred in girls. Extremity fractures and head injuries were the most common injuries with older children and boys more likely to sustain extremity fractures while younger children and girls were more likely to have head injuries or concussions. Life threatening injuries were rare, which is reassuring.
(more…)
MedicalResearch.com Interview with:John W. O'Kane M.D.
Associate Professor Family Medicine and Orthopaedics and Sports Medicine
Medical Coordinator, U.W. Intercollegiate Athletics
University of Washington Sports Medicine Clinic, Seattle
MedicalResearch.com: What are the main findings of the study?Dr. O’Kane: In 11 to 14 year old female elite soccer players the concussion incidence was 13% with a rate of 1.2 per 1000 athletic exposures. Symptoms lasted a median of 4 days and players with light or noise sensitivity, emotional lability, memory loss, nausea, and concentration problems took significantly longer to recover. Heading the ball accounted for 30.5% of concussions and the vast majority of concussions (86%) occurred in games. The majority of players (58.6%) reported playing with symptoms and less than half (44.1%) sought medical attention for their symptoms. Those seeking medical attention were symptomatic longer and were less likely to play with symptoms.
(more…)
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptRejectRead More
Privacy & Cookies Policy
Privacy Overview
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
