There is Nothing Mild About Mild TBI You Can Do Something About It

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greetings

my name is dr namasthandra a

distinguished professor of biomedical

engineering

at the new jersey institute of

technology today

i want to talk about something new to my

heart and brain

there is nothing mild about mild

traumatic brain injury and you can do

something about it tbi can be cast

from just a blow to the head as in a

fall

sports or car accident this head injury

occurs

then the head is violently hit against

any object

or just violently shaken this is blunt

tbi

it can also happen if there’s a sharp

object

like shrapnel or bullet penetrating the

head

this is ballistic tbi the third kind

blast tba occurs if you are in a combat

zone

as in a blast attack this can also

happen

in an industrial accident like in beirut

or insurgent attack as in boston

no matter what the cause is a blow

a bullet or blast the injury is the same

meet mr pandi the year is 1987

and it is a cool december day in madras

india pandi a production engineer

in a large corporation was riding at

his motorcycle on the way to work

you have to take a short turn to avoid

an oncoming car

the cycle slipped the helmet flew away

and he was dragged for about 100 meters

with his head

pulled along the pavement he became

unconscious

and was treated in the hospital and sent

home

he partially recovered and went back to

work

however within six months he was

paralyzed

lost his job became bedridden

until his death in 2012.

for more than 25 years

mr pandy support from tbi

is one of about 69 million people

worldwide

affected by tbi every year

tbi did not just destroy his life

but his entire family they could never

ever fully recover there is nothing mild

about my tbi

fondy was my brother and her family

with a very heavy price you should know

more about tbi and do everything to

prevent it

tba can be classified into none mild

moderate severe or

a clinical schema a clinical coma scale

is used to code the incoming patient and

treatment

strategies the score is based on verbal

ocular and motor responses right after

injury

many times the short or long term

outcome of the patient may or may not be

predicted

by the score in years alone

dba occurs every 15 seconds and someone

dies

every five minutes about

75-90 percent of all tba cases

are mined my tbi is also called as

concussion

concussion will not show in mri or cp

scan

concussion can have very serious effects

such as memory problems learning

disabilities

sleep disturbance and depression there

is

absolutely nothing mild about my tbi

this problem becomes even worse with

repeated

concussions how come

when there are no symptoms initially all

these problems develop

in later life human brain

is a most complex critical and delicate

organ

it is more complex than any other organ

or any other man-made device including

a spacecraft there are many types of

brain cells

while the lead actor is neuron it has

some important supporting actors

like astrocyte and microglia the

chemical environment of the brain

is very tightly controlled and this is

very critical for the neurons to talk to

each other

there are about 87 billion neurons

and they connect each other with more

than 1 000

trillion connections this is more

than the number of stars in the entire

universe

if you add or subtract any biochemicals

the communications becomes difficult or

even impossible

this is what happens during pbi

we have thick skull so why does injury

happen

the brain inside the skull is more like

a

firm jello locked in a very rigid

structure

inside the skull it is anything but

smooth it is lined with hard ridges and

projections

even with a minor bump or fall your

brain shakes

and hits against those ridges and rips

many neurons can you imagine that we

have about 100

000 miles of blood vessels supplying

oxygen

and energy the joule sometimes breaks

blood vessels

to let blood spill into the brain

while oxygen is good blood is very bad

acetate killing neurons if the blood

leak is

very widespread the brain

will temporarily shut down leading to

loss of consciousness

even if nothing shows up on the outside

the brain is swelling bleeding and

destroying the delicate

balance of act or the neural

communication network

our brain integrates all the sensory

information

by talking to each other all the time

there are different brain regions that

control

different activities like hearing and

vision

a slightly different joke can induce

different regions

with different functional outcomes if

the brain chemistry is altered from the

jolt

the communication environment is changed

with blood leaking into the brain it may

shut down temporarily

causing concussions or permanently

causing coma

this may happen immediately or take time

days months or even years

but believe me through the jolt

you have altered the brain and hence

memory

and all your behavior depending on how

hard you are hit

that damage may recover in a short time

for a long time

or not at all in our lab

we have exactly recreated shock produced

by a blast

the shock profile varies based on how

far you are from the blast

and how strong the blast is we look for

designing

and testing better protective

environments like helmets

goggles and tabs we determine the

condition for mild tbi

using animal models we explore the

mechanisms of injuries say blood vessel

breaking

or increase in oxidative stress or

neural inflammation

we then examine the brain section by

section

for cellular and subcellular activities

we can see which region of the brain

gets affected because waves come from

front side or back

then any part of our body gets injured

almost instantly immune cell sends

chemical sickness through the blood

and get a lot of help to fight

and recover brain is different

it has got its own defense mechanisms

since blood is not allowed to cross into

brain

microglia the special brain immune cell

gets activated when the brain chemistry

is altered

if microglia is activated that means

the brain is compromised in these

figures you see

that microbial gets activated and stay

happy for a long time

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no mri or ct can detect this

the struggle better injury and recovery

can be shot

long or never this depends on how strong

the blow is

and how often it occurs

natasha richardson is a famous tony

award winning actress

and she was skiing in cuba she slipped

and fell natasha is the wife

of actor liam neeson she felt fine

she was supposed to go to the hospital

but was feeling fine

signed the waiver and walked home

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she died in the next few days due to tbi

she was not wearing a helmet injuries

may be harmless in the beginning

symptoms may take time to develop it may

not

always lead to death but loss of memory

change in behavior and may also lead to

other neurological diseases

like alzheimer’s disease

how do you protect children and elderly

people from tbi

make sure that the children wear helmets

while on bike skateboard or any other

sports

you can and should always protect your

head

as though your life depends on you it

does

may have an elderly parent or you will

be one in the future

let elders stay in a clutter free

single floor fully padded house

if they get hurt make sure that they are

fine not for hours but days

if in doubt consider doctor

prevent heavy injury if we can always be

aware of what can happen

recognize when it happens and have a

watchful eye

there is no nothing more important than

brain

by acting now you can help people

like your brother pandy and millions

more

and their families there is nothing mild

about my tbi you can

and should do something about it thank

you