New Developments in Diagnosis and Treatment of Traumatic Brain Injuries


New Developments in Diagnosis and Treatment of Traumatic Brain Injuries

In our last post, we discussed the starting of football season this week here in Indiana and Illinois, and how football players of all ages, but especially children and teenagers playing football, are at a high risk of brain injury while playing the game.

Traumatic brain injuries are serious injuries that cause permanent damage to the human body.  Psychological impairment as well as physical disabilities and emotional harm can all be the result of a football brain injury.

For many who have enjoyed some success on the football field (or while playing soccer, rugby, or other high-risk for TBI sports), the reality is that they have already suffered some kind of brain injury.  Many may believe it was only a minor concussion.  Maybe they know that they are permanently impaired.

For a heart-wrenching story on the reality of an exceptional athlete discovering the realities of a permanent brain injury, read the Business Insider’s article, “Warren Sapp on the effects of football on his brain: it’s a ‘frightening’ and ‘weakening’ feeling ‘because you feel like a child’”.

Hope for the TBI victim lies in medical research and technological advancements that may help to alleviate or end their TBI symptoms.  Together with sufficient financial resources to cover the costs of these new advances (which often must come from injury claims and lawsuit against those responsible for overseeing these players), these developments bring hope to many that there may be a way to resolve what is now a permanent harm.

1.  Tracking Eye Movements: New Method of Diagnosing Brain Injuries

For those that suffer brain injuries, there can be difficulty in coordination of their eye movements.  Their vision may not be impaired.  It is the ability of their two eyes to work together, jointly, as they did before the traumatic brain injury.

Now, things may be changing to help these brain injury victims as well as helping others who may not yet be diagnosed with brain trauma and brain injury.

Developed by Dr. Uzma Samadani, M.D., Ph.D., who is also a neurotrauma consultant to the National Football League, this new technology is called the “EyeBOX™.” It is a new device that tracks eye movement in the patient.

As described in the Journal of Neurosurgery, the EyeBox detects abnormalities noninvasively by measuring the effects of elevated intracranial pressure (ICP), through eye movements.  See, “Elevated Intracranial Pressure and Reversible Eye-Tracking Changes Detected While Viewing A Film Clip,” was released online by the Journal of Neurosurgery.

EyeBox recognizes that TBI can result in the swelling of the brain, which puts pressure on the skull.  This means ICP develops.  Before EyeBox, the way to test for ICP was to drill a hole into the skull in order to measure it.

With EyeBox, there is no invasive procedure.  The intracranial pressure (ICP) is measured via the patient’s eye movements.  ICP is a serious symptom of a brain injury.  It can cause headaches, permanent vision problems, cognitive (thinking) impairment, and even death.

From their June 2017 press release, explains EyeBox inventor Dr. Uzma Samadani, M.D., Ph.D,:

“Diagnosing elevated ICP noninvasively will enable many people with traumatic brain injuries to receive an appropriate diagnosis and treatment.  EyeBOX was designed to measure ICP by tracking eye movement to quickly, accurately and noninvasively diagnose concussions and other traumatic brain injuries.”

The EyeBox is particularly exciting for use in children who have suffered brain injuries.  These may be children  who have TBIs from accidents or concussions from playing school sports.

“I see hundreds of kids with varying degrees of concussions in my practice, and rapid, accurate diagnosis is essential to determining whether a concussed child can return to sports,” said Christina L. Master, M.D., pediatric primary care sports medicine specialist at the Children’s Hospital of Philadelphia, who is currently conducting studies using EyeBOX in a pediatric population.

2.  Change in CT Classification of TBI for Better Prognosis

New research findings published this month by Stockholm medical researchers describe how they have found changing how TBI patients are classified helps to get the TBI victim a better diagnosis of their brain injuries as well as a more precise prognosis.  See, Eric Peter Thelin et al. Evaluation of novel computerized tomography scoring systems in human traumatic brain injury: An observational, multicenter study, PLOS Medicine (2017). DOI: 10.1371/journal.pmed.1002368.

This discovery impacts all types of TBI victims.  Brain trauma here can involve bleeding inside the brain itself, or around the brain and under the skull.  The bleeding is caused by a blow to the head, which is the result of worksite falls, school sporting injuries, motor vehicle accidents, criminal assaults, or other incidents where the head suffers a severe injury.

Currently, someone suspected of a TBI is diagnosed by a CT scan.  The CT scan is reviewed by the health care providers, as they attempt to determine which type of bleeding is involved in the brain injury.

This new approach to classification of TBI victims deals with how CT classification of the TBI occurs.  It is called the Stockholm or Helsinki CT Score, and it is found to be more reliable for the patient than the current CT classification methods.

From Dr. Eric Thelin:

“The problem with the earlier CT classification systems is that they are very crude and based on old patient materials. Improved and more updated CT classification systems have long been necessary.  The results show that by making a correct assessment of the first images obtained by CT, we can better predict how well the patients will fare. This is extremely useful as it gives the clinicians better information as to how their care can be optimized.”

3.  New Drug ISRIB Can Help Recovery from TBI

Finally, a new drug has been debuted by medical researchers that has been discovered to help  TBI victims recover from their brain injuries.  The drug is called ISRIB.

In a research study published in the National Academy of Sciences, this new medication can be used not only immediately after the injury has occurred, but it is also helpful if administered days or weeks after the TBI victim has suffered the brain trauma.

See, Austin Chou, Karen Krukowski, Timothy Jopson, Ping Jun Zhu, Mauro Costa-Mattioli, Peter Walter, and Susanna Rosi Inhibition of the integrated stress response reverses cognitive deficits after traumatic brain injury PNAS 2017 114: E6420-E6426.

What does ISRIB do for the TBI victim?  The drug can restore function to the brain, helping memory function as well as the patient’s ability to learn and retain.

ISRIB has been successful in testing done on mice with concussions and brain injuries.  However, researchers admit that they are not sure how the drug works and how the brain is helped by its administration.  It works, but they aren’t sure how it works.

Right now, ISRIB remains in the testing phase.  However, researchers are excited with their findings and are hopeful that the new TBI recovery drug will be made available to TBI victims in the near future.

From the study:

Currently, there are no effective treatments for patients suffering from chronic TBI-induced cognitive impairments. Here, we found that suppression of the integrated stress response (ISR) with a drug-like small-molecule inhibitor, ISRIB, rescued cognition in two TBI mouse models, even when administered weeks after injury. Consistent with the behavioral results, ISRIB restored long-term potentiation deficits observed in TBI mice. Our data suggest that targeting ISR activation could serve as a promising approach for the treatment of chronic cognitive dysfunction after TBI.

Advances in Treatment of TBI Victims

For those who have suffered traumatic brain injuries, as well as their loved ones, the work being done to advance the treatment and cure of TBI is vital.

We monitor these developments, as well, not only for these TBI victims but because these developments are often a part of a TBI claim or lawsuit.

All too often, TBI victims must seek financial redress from those who have been responsible for the incident that has caused their brain injuries.  These developing TBI advancements must be considered as part of the justice that all TBI victims deserve.  Let’s be careful out there!

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