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