A recent systemic review of the literature, just published in the Journal of Athletic Training, 2024; 59(1): 49-64, concludes that “vestibular and oculomotor screening are prognostic of time to recovery” from concussion. Positive findings on these assessments “consistently predict longer recovery.”The authors therefore recommend that vestibular and ocular motor screening be part of the standard of care for assessment of concussion patients. Download the full article in PDF format. Symptoms of oculomotor (related to the motion of the eye) and vestibular (related to the inner ear and sense of ba ..read more

As reflected in the posts on this blog over the last several years, scientific understanding of “mild traumatic brain injury” (Mtbi) – often referred to as “concussion” – has advanced considerably over the last 30 years. Unfortunately many physicians, including those on the “front lines” for these injuries–in emergency rooms and primary care clinics–have not kept up with this evolving science.  In emergency rooms, the focus is typically on ruling out catastrophic injuries. The signs and symptoms of concussion are often missed.  Even where the symptoms are recognized, many physicians ..read more

A large TRACK-TBI cohort study published in JAMA Network Open finds incomplete recovery at 5 years in 53% of mild traumatic brain injury (mTBI) patients, dictating need for longer term rehabilitation. A multi-center transforming research and clinical knowledge in TBI (TRACK-TBI) cohort study published March 20, 2023 in JAMA Network Open followed 1196 patients at 18 level 1.0 trauma care centers in the US over five years, including patient with mTBI, patients with moderate-severe brain injury (msTBI) and orthopedic controls. It found persistently elevated rates of incomplete functional outcomes ..read more

A recent study published in JAMA Network Open finds that patients with a history of traumatic brain injury (TBI), including mild TBI (mTBI), are at significantly greater risk of developing chronic cardiovascular, endocrine, neurological and psychiatric disorders. This proved to be true in all age groups, including younger adults (18-40). This study is important because, as the authors note, “the risks of incident comorbidities in previously healthy patients who sustained mTBI and msTBI (moderate-severe TBI) has not previously been reported.” The most important takeaway of the study is that “pa ..read more

One of the most frequent questions I get from TBI clients in my Vermont law practice is: “Are there alternative therapies I can explore to help support my recovery from a traumatic brain injury without risking further harm?” Physicians practicing “integrative oncology” offer a multi-disciplinary approach to patient care for cancer that implements complementary therapies in collaboration with conventional treatment. Although TBI medicine is not as well organized, the peer reviewed TBI literature does support similar evidence-based complementary therapies for the treatment of TBI. Several have b ..read more

A small region of the brain called the anterior thalamus could hold the key for restoring memory function after a traumatic brain injury. Researchers in New Zealand and the University of Oxford in the UK have shown that targeted electrical stimulation of the anterior thalamus could help with memory restoration in patients with brain injury. Given how complex the brain is, scientists do not fully understand the extent to which memory impairments following TBI or stroke are caused by irreversible tissue loss and are therefore not treatable or by treatable dysfunctions in the wider brain networks ..read more

Earlier this year the Brain Injury Association of America (BIAA) issued an open letter encouraging all individuals with brain injury to get a COVID vaccine. The letter cites evidence from the American Academy of Neurology that anyone with a neurologic disorder such a brain injury is particularly vulnerable to diseases like influenza and COVID: “When one is infected with COVID-19, the virus attacks the “weakest link” it finds in the body, which is why individuals with longstanding chronic medical conditions are at the greatest risk for infection, complications and even death,” explained BIAA N ..read more

Most personal injury lawyers have represented clients suffering from the chronic consequences of concussion and musculoskeletal injuries following a rear end collision that caused minimal damage to the vehicles involved. This blog has reported on countless scientific studies showing that in some patients concussions can have long-term, chronic consequences. The standard defense employed by insurers in minimal damage rear end collisions (which they call “MIST” cases) is to argue that any injury is improbable in these accidents because the forces involved are similar to the forces involved in ma ..read more

A recent Defense Department/University of Pittsburgh study confirms three important points made in prior posts: So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations); that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and that interventions targeted to the individual presentation of the injury (whether it is predominantly vestibular, cognitive, oculomotor, headache, sleep or mood related, or some combination) can reduce symptoms in otherwise i ..read more

A research report from the University of Texas Medical School, just published in Frontiers in Neurology, finds a correlation between Diffusion Tensor Imaging (DTI) findings and cognitive assessments in patients with chronic complaints after concussion, providing evidence that DTI imaging may be a reliable biomarker predicting the severity of cognitive decline following concussion. (DTI is an MRI technique that detects microstructural changes in white matter such as the changes that can occur as a result of “diffuse axonal injury” in brain injuries including concussion.) The researchers analyze ..read more