Can Video Games Help With Brain Surgery Rehabilitation?

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Do video games help recovering brain surgery patients? As reported in an article on Gizmodo, video games aided the recovery of Eric Levasseur, a patient who had to undergo 7 brain surgeries in an eleven-month period to stop his epileptic grand mal seizures. Eric’s side effects after the surgeries included memory loss, impaired speech, and short-term memory impairment.

According to the article, Eric’s doctor recommended brain training games on Luminosity, but the patient found them too difficult and too much like work, and elected to play Destiny, a multiplayer online game instead, with his doctor’s approval. Eric was able to play for increasingly longer periods without any noticeable impairment, and soon he was mapping out strategies and earning a reputation among players, as stated in the article.

In the game of Destiny, a player must have friends to go on Raids, as discussed in an article on the Daily Dot. As Eric had difficulty communicating, Raids with other players were a problem for him. When Eric’s wife, Brittany, included that information in a Reddit post, the Destiny community organized Raiding parties to assist him. As covered in the Gizmodo article, Eric has a long recovery road ahead, but playing Destiny could help make it shorter, and easier to endure.

There is evidence to suggest that video games can help victims recover from injuries to the brain. A Medpage Today article reports on a study conducted in Vienna in which TBI patients used video games to effectively improve their coordination. According to the article, researchers noted significantly improved scores for gait, balance, and functional reach in patients who participated in a virtual therapy session supported by Microsoft Xbox Kinect. Researchers also found that coordination, dynamic stability, and precision from baseline were greatly improved by this video game therapy.

The Games for Health Journal published an abstract of a structured literature review of the use of video games and virtual reality for rehabilitation after TBI. These researchers concluded that, although the evidence that virtual reality helps improve motor and cognitive function is limited, this approach does have the potential to provide alternative rehabilitation therapy for TBI patients.

The Brain Injury Peer Visitor Association offers a number of tools and aids for recovering brain injury patients. Links to various games are provided as helpful resources. Luminosity is listed and described as brain training that is effective. According to the association, Luminosity can make you smarter and more mentally fit, regardless of your age. The association also provides links to arcade games, strategy games, card games, and word games among its many resources.

Celebrity Brain Injury Spotlight

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Recovery from a brain injury can take years, or in some cases, the injured person can never recover full cognitive ability or motor control. The brain is a very difficult organ to treat, and while some patients, with time, can recover all or most of their abilities, others will live with long-term impairments. The degree of the injury as well as the location of impact are issues that affect the how well any patient will recover.

Case in point is comedian and celebrity Tracy Morgan, who almost a year after being involved in a terrible collision, is still suffering from headaches and problems with memory, as reported by NBC News. The source also revealed that almost 275,000 Americans suffer from a traumatic brain injury every year. There are many well-known celebrities who have suffered a significant change after a brain injury other than Mr. Morgan.

Some of the celebrities we know and love that have suffered a TBI include sports figures, actors and others. Some of the more recognizable celebrities who have dealt with the aftermath of a brain injury include names such as George Clooney, Gary Busey, Donald Sutherland, and Stevie Wonder. Extreme athletes who have suffered a TBI include Jeremy Lusk, Bethany Hamilton, Kevin Pearce and many others.

Car accidents and falls are the most common ways a regular person gets a traumatic brain injury, as was the case with comedian Tracy Morgan. The news source reveals that the damage has led Mr. Morgan to wonder if he will ever be able to return to comedy.

An impact on the head causes the brain to knock back and forth within the skull, ripping and tearing delicate connective tissue, often with bleeding, adding a serious risk associated with swelling and pressure, and the resultant lack of oxygen to the brain. Medical science has not advanced to the point in which the level of recovery for a victim can be accurately predicted, and only time can answer that question.

The brain has the capacity to “rewire” and to create new pathways around damage, but how each individual’s body responds to damage varies widely. Many people require memory aids to keep track of daily tasks, while others need full-time nursing care, and are unable to perform everyday tasks such as talking or remembering loved ones, much less walking, cooking meals and other simple tasks.

Those who have suffered a traumatic brain injury, whether in a car or motorcycle accident, or in a fall, may have a long road to recovery. It is hoped that new technologies and advances in medical science will increase the numbers of victims who are able to fully recover from a TBI.

A Brain Injury Doesn’t Have to Be the End

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Moving Forward from a Brain Injury

Following an accident, the words “brain injury” are among the scariest a patient’s family can hear. Many assume that there will be no recovery, or, if there is, that their loved one will bear no semblance to the person they once knew. Indeed, for the first few weeks or even months, it’s difficult to know what the eventual outcome will be. The person could be unconscious, in a coma, or in a vegetative state. Even once a patient regains consciousness, even basic responsiveness to stimuli may be slow to return, and unpredictable.

Despite these potential dire signs, there is no need to despair. Many people who suffer brain injuries do make extraordinary recoveries, and go on to live long and full lives. Take Matthew Evans, for example. At the age of eight, he fell off a cliff and suffered a stroke, which caused severe brain damage. Initially, doctors did not expect Evans to be able to continue attending school. In spring of 2015, however, he walked across the stage and earned his Bachelor’s degree from Western Michigan University. Though he is still partially paralyzed, he was able to take coursework alongside his peers, and is proud to have overcome these challenges to earn his diploma.

Brain Injury Recoveries: Factors in a Positive Outcome

Brain injuries are complex conditions, and their treatments are long and complex, too. There are many factors that affect outcome. Though the rate of improvement in brain function is often fastest during the first six months, people experience widely varying rates of improvement. CT scans or MRI’s are not necessarily predictive of long-range outcomes, even when the first test results are alarming. A patient who shows severe bleeding in the brain after an accident may make a full recovery (of course, the inverse is true—promising early scans can be misleading as well).

The work continues long after leaving the hospital: for years, patients must work on cognitive exercises and organization. Intelligence and emotional response to the process varies. People with high IQ’s often recover faster, although sometimes their awareness of the situation, and hence frustration, can be a significant emotional stumbling block. It’s very important to get cognitive treatment and therapy as early as possible; though the brain can heal by itself, early treatment tends to improve neurological outcomes. Most people’s lives are forever changed by a brain injury, and few cognitively feel exactly as they did prior to the injury. But though their lives will be different, they can be just as fulfilling, and incredible progress is possible.

Professional Sports and the Risk of Brain Injury

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When San Francisco 49ers linebacker Chris Borland made the decision to retire in his prime, it once again called attention the risks of suffering a traumatic brain injury that professional athletes face when playing America’s most popular sport. Many players are looking at the future and considering their health as more important than a career in professional football. A massive paycheck, at the end of the day, cannot balance out the health impacts that many of these athletes suffer later in life, or take place while playing the game. Borland felt that he didn’t want to wait until he suffered symptoms to quit the game; that could be too late, and he felt that he would prefer to live a long, healthy life.

The NFL has been avoiding this issue, and has consistently downplayed the symptoms that athletes playing pro football face after repeat concussions. There was much research that revealed that players were susceptible to various health problems from repeated head trauma, and despite the research to the contrary, the NFL was responsible for funding a study that claimed that the sport did not pose any extraordinary risk to players, and has even blamed journalists for shining a light on the problem, rather than dealing with traumatic brain injuries as a real issue of concern that must be addressed and resolved.

The Impact on the Brain: Repeated Concussions

Findings released by Dr. Bennet Omalu in 2005, as reported by Frontline, revealed that the autopsy findings on Pittsburgh Steeler Mike Webster who passed away at the early age of 50 showed that he had the brain of a much older person. PBS reports that other autopsies on former NFL players clearly indicated that in 76 out of 79 cases, the players had evidence of CTE (Chronic Traumatic Encephalopathy, a degenerative disease of the brain associated with repeated brain trauma and concussions).

Whether the NFL finally admits to the problem and addresses it or continues to try to downplay that this is a serious issue of concern, it has become ultimately clear that sports professionals are at high risk of suffering serious health problems associated with the pounding they take to the head in tackling and being tackled. Children involved in sports are also at risk of such injuries, and parents would be prudent to discuss these issues with coaches and trainers before allowing a child to participate in a sports program that could endanger their health for the long term.

How a Car Crash Can Change Your Life Forever

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A car crash is always unforeseen, and the consequences are often life-changing. A serious injury that requires many months of medical treatment is often chaotic and emotionally and physically draining, even for a minor injury.

Head injuries are a common injury in an auto collision, and these injuries carry very serious consequences. In many cases there will be a permanent impairment of cognitive abilities, motor skills or both. Even a minor concussion can leave the person with severe headaches, emotional instability, depression and other symptoms. Some of these symptoms may not be immediately recognized as being associated with a head injury.

One of the most difficult situations is when the memory has been affected, either short memory or long term memory. An unusual case reported by Business Insider involved a racecar driver, Fernando Alonso. His car hit the wall at a speed of about 93 mph. He lost consciousness for a period and appeared confused, and due to his symptoms, was airlifted to a hospital for a medical evaluation.

Upon being questioned by medical professionals at the hospital, Mr. Alonso had no memory of the prior twenty years of his life. The brain injury he suffered affected his memory to such a degree that he had literally no memory of two decades, and considered himself to be 13 years old. This form of memory loss is termed retrograde amnesia, and can be a symptom of a serious brain injury or concussion. Some people recover all or most of the lost memories, while others cannot, and must relearn the entirety of their lives, including meeting spouse and children as if for the first time – a difficult situation for everyone. Thankfully, Mr. Alonso is reported to have recovered fully.

Another type of amnesia, called anterograde amnesia, leaves the person unable to create new memories. The inability to retain new information makes life extremely difficult, with challenges that are almost unimaginable. What was learned in one moment can be forgotten almost instantly.

Specialists who work with those suffering from brain injuries have developed methods to assist the person to deal with this serious impairment. Some people must be retaught how to speak, walk and do any of life’s most basic tasks.

The prognosis for any victim in a car accident is often uncertain, particularly in cases of brain injuries. While some patients recover fully, others may never regain their abilities, or will live with significant mental impairments. Medical professionals cannot advise families of what to expect with regard to a full recovery, as each person varies in response to treatment.

Other life-changing injuries commonly associated with car accidents include spinal cord injuries and paralysis, disfiguring injuries and amputations.

A car accident is often not strictly speaking, an accident. It is the result of an act of negligence, when another driver acted by failing to exercise reasonable care for the safety of others, and in doing so, injured others. Acts of negligence include drunk driving, speeding, texting while driving and other types of distracted driving, as well as drowsy driving. If a driver gets behind the wheel and puts others in danger, they can be held accountable for injuries and loss of quality of life through an insurance claim or personal injury lawsuit. These legal actions fall under the jurisdiction of the state’s civil court system.

Apps for People With a Brain Injury

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Living with a brain injury has challenges that are difficult to overcome, particularly when memory has been affected. Technological advances have offer new hope for those who are suffering from mild to severe memory loss, with specialized apps for TBI victims to stay organized, be reminded of important dates, appointments, people and a wide range of other resources.

Some of the resources now available include apps for people who are nonverbal, allowing the patient to answer yes or no – often the first step towards recovery in treating traumatic brain injury, and providing medical professionals with information about the level of damage. More advanced apps give voice to those who have lost the ability to speak. There are apps that have specialized memory games, stress management tools to assist with mood stabilization and anger management, word-finding apps, and daily task apps to assist with keeping up with daily duties and appointments.

Cognitive Rehabilitation: New Options

Patients in rehab often have a long road to recovery. There are several apps available that provide solutions for the current cognitive goals, including visual problem solving, and apps that address the issues surrounding short term memory loss, or that provide a total cognitive workout. Many brain injury victims have trouble with practical skills such as counting money, and new resources are available to assist with this process, and can eventually give the individual the ability to live independently.

TBI victims may suffer from dysarthria (an unclear articulation of speech) and dysphagia (difficulty swallowing). Certain apps on the market provide support for these conditions. “Pocket Pairs” helps patients practice producing words in pairs, and iSwallow provides reminders for swallowing exercises, including video instructions.

A family GPS tracker allows the chosen group to keep track of the location of each member of the family, and others allow for emergency medical information to be transmitted in cases of emergency. A person who tends to lose their way can get voice and visual directions.

These advances provide new types of resources for brain injury patients. Families can get assistance from brain injury rehab specialists about which apps to use throughout the recovery process, and how to teach a family member to operate the various apps. As the patient improves abilities, more complex apps can be installed.

How to Live With Brain Injury

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Every year in the United States, about one million people seek emergency room care due to a traumatic brain injury (TBI), and an estimated 230,000 people are hospitalized. Traumatic brain injuries range significantly in severity, from a mild concussion that has no long-term impact on health, to a severe injury that directly impacts every facet of life. For those in the latter category, establishing a new normal is especially difficult, but with motivation and hard work, it is possible to enjoy a sustained quality of life.

The areas of life that are impacted by a TBI will depend on which parts of the brain were injured, as well as the severity of the TBI diagnosis. While it’s nearly impossible to accurately gauge exactly how much impact a TBI will have on a person’s life in the long term, there are general steps a person can take to help them overcome many of the challenges associated with a TBI.

Attention and Concentration

A traumatic brain injury can render you unable to focus or concentrate on multiple tasks. As a result, you may suffer from restlessness and may become easily distracted. To combat those hurdles, remove any potential distractions prior to starting a task. Do it no matter how seemingly simple a task is (answering a phone call) or how difficult (writing a letter). As you gain confidence, you will notice a slow progression in your ability to complete increasingly complex tasks, and eventually the distractions will no longer be a hurdle to completing them.

Communication

Communication can also be problematic for TBI victims. You may find yourself having a hard time coming up with the right word, following conversations, using facial expressions, and reading the emotions of others. To help regain abilities in this area, maintain conversations with only one person at a time, speak slowly and deliberately, and create a signal that others can use to let you know when you have gone off topic. The more you practice these steps, the easier communicating will become.

Organization, Planning and Retaining

Scheduling appointments, making plans, and performing multi-step tasks can be a challenge for people who have a TBI. So, start making and keeping lists of things you need to do and create step-by-step instructions for tasks that you find difficult. If a task is simply too complex, break it down into smaller steps. When faced with a task that you cannot figure out, focus on the desired end result and work backward.

Another common problem for victims of TBI is the inability to recollect events and retain information. You might recall memories from long ago, but short term memory and the ability to grasp new information are generally affected. Write down a list of daily routines and activities and keep a copy by your bed, on your refrigerator, in your car, or wherever else you may need it. Use notebooks, wall calendars and smartphone apps to help you along the way, too.

Also, the more relaxed you are and the more rest your brain gets, the better it will function. So, get plenty of sleep and reduce anxiety triggers. One way to lower anxiety is to review your notes and practice new tasks regularly. That way, you will become more familiar with them, and that will lead to reduced stress.

A traumatic brain injury can be a setback, but there are countless ways you can help yourself along the path to recovery. Even if you don’t regain full capacity, with patience and practice you can still function at a high level. The quality of life you enjoy will be directly impacted by your level of motivation and long term commitment to recovery.

Progesterone and TBI

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Traumatic brain injury (TBI) results from a blow or jolt to the head or a penetrating head injury that disrupts brain function. As reported on Brainline, of the 1.7 million people in the U.S. who suffer TBI every year, 52,000 die, 275,000 are hospitalized, and 1.365 million are treated in emergency rooms and released. Severe TBI can cause unconsciousness or amnesia and may result in long-term independent function problems for victims.

Hopes for Progesterone and TBI in the Scientific Community

Progesterone is a female hormone involved in menstrual cycles and reproduction that can also be found in the brains of both males and females. According to a Life Extension Magazine article, neuroscientist Donald G. Stein, PhD, and some of his colleagues noted that some females recover more completely and quickly from brain injury than males do, and began investigating the neuroprotective effects of progesterone more than 30 years ago.

Studies with animals have indicated that progesterone may reduce damage to the brain and improve recovery from TBI. As reported in the Life Extension article, Dr. Stein’s successful experiments using progesterone to alleviate the effects of brain injury to rats eventually led to clinical trials using progesterone to treat humans suffering from TBI.

In 2012, the National Institutes of Health (NIH) published the findings of a study conducted to assess the safety and effectiveness of progesterone for treating patients with acute TBI. Data for the study was obtained from 3 randomized controlled trials of progesterone versus placebo for treatment of a total of 315 acute TBI patients. This study concluded that progesterone may improve neurologic outcome for TBI victims, but that evidence was insufficient and further controlled trials would be required.

Disappointing Results of Further Clinical Trials

On December 25, 2014, the New England Journal of Medicine published the results of a double-blind clinical trial in which 882 patients with moderate, moderate-to-severe, or severe acute brain injury were randomly given either progesterone or a placebo within 4 hours after injury, with treatments continuing for 96 hours. Most of the patients received their injuries through motor vehicle accidents.

The results of the trial were disappointing, to say the least. There was no significant difference in favorable outcomes for patients treated with progesterone as compared to those treated with a placebo. The conclusion of the study was that progesterone has no clinical benefit for acute TBI patients.

According to a February 10, 2015 Health News article, the study, which was funded by NIH and known as Pro TECT-III, began in April 2009 and continued to October 2013. The University of Cincinnati Medical Center was among the 49 trauma centers that participated in the study and enrolled 85 of the 882 patients involved. Patients were followed closely by researchers for 6 months after treatment.

As reported in the Health News article, Jordon Bonomo, M.D., lead investigator for the trial in Cincinnati, said that the research team was disappointed to learn that progesterone was not as helpful as had been hoped. Dr. Bonomo also commented on the importance of developing new therapies to treat TBI.

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Despite New Study’s Findings, Parents Should Take Potential Child TBI Seriously

Let’s say your child is playing on a swing at school, falls off and hits his or her head on the ground, causing a bruise or bump to form. As a parent, should you be concerned that a serious child brain injury has occurred?

According to a recently published study, if your child’s only sign or symptom after the accident is a headache, there is actually a fairly low risk that the child has suffered a “clinically important” traumatic brain injury (ciTBI), or a brain injury that is likely to require hospitalization or surgery.

However, out of an abundance of caution, you should still have your child examined by a doctor after one of these “bumps on the head.” You should also keep a close watch for signs and symptoms of TBI in the weeks that follow.

Study Finds Low Risk of TBI in Children with Isolated Headaches

Researchers from New York’s Presbyterian Morgan Stanley Children’s Hospital conducted the study, which was reported February 2 in the online edition of the journal, Pediatrics.

The study analyzed data from a prospective observational study of children between ages 2 and 18 with “minor blunt head trauma,” or head trauma registering a score of 14 or 15 on the 15-point Glasgow Coma Scale.

As Reuters Health describes, the children were placed into two groups: Those with isolated headaches and those with signs and symptoms in addition to a headache.

Out of 2,462 children who suffered only isolated headaches, none were found to have ciTBI. In contrast, out of 10,105 children with more than an isolated headache, 162 had ciTBI (1.6 percent).

In other words, the risk of serious brain injury is 1.6 percent higher when a child presents signs and symptoms that go beyond an isolated headache.

Additionally, commuted tomography (CT) scans identified ciTBI in only three out of 456 children with isolated headaches (0.7 percent). Out of a group of 6,089 children with additional signs and symptoms, CT scans revealed ciTBI in 271 (4.5 percent). In other words, the risk of ciTBI was 3.8 percent higher.

This research follows a study published online in September 2014 by JAMA Pediatrics that analyzed children with isolated loss of consciousness after suffering mild blunt head trauma. The researchers in that study found there was a “very low risk for ciTBI” among children with that lone symptom and concluded that they “do not routinely require” CT scan evaluations.

How Should Parents React to Head Injuries?

While the these studies, taken together, may suggest that parents have little to worry about if a child merely bumps his or her head and suffers only an isolated headache or loss of consciousness, it is still important to take these injuries seriously.

As the Brain Injury Association of America notes, “62,000 children sustain brain injuries [each year] requiring hospitalization as a result of motor vehicle crashes, falls, sports injuries, physical abuse and other causes.”

Pay attention to signs and symptoms of TBI that a child may develop in addition to headaches or loss of consciousness, which the Children’s Health Center of Atlanta describes as:

  • Fluid draining from the ears or nose
  • Confused or dazed looks
  • Inability to see or speak clearly
  • Repeated vomiting
  • Seizures
  • Severe neck pain
  • Progressive drowsiness
  • Weakness in the arms or legs
  • Inability to remember people or places.

If your child has suffered an apparent head injury, don’t do the evaluation yourself. Instead, take your child to see a doctor as soon as possible. Allow the doctor to do an examination and to consult with you on whether to order additional testing such as a CT scan or X-ray.

Brain Injuries Caused by Medical Malpractice

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A 26-year-old woman who had recently graduated from medical school and planned to become a pediatrician died after going to a Pennsylvania hospital complaining of days of headaches. The team of doctors who treated her did some tests and gave her medication, but did not order a head -imaging scan that would have detected her life threatening condition, a blood clot.

The patient was at the hospital more than 40 hours before a neurologist examined her and she was within hours of death before she was given clot-busting medications, according to a newspaper account. She eventually suffered massive cerebral hemorrhaging, a stroke, brain damage, and died. The young woman’s parents filed a medical malpractice lawsuit claiming the doctors failed to diagnose a blood clot that should have been obvious.

Approximately 30 percent of all injury related deaths can be attributed to some type of brain trauma, according to the Centers for Disease Control and Prevention. While the majority of brain injuries happen as a result of falls, traffic accidents, or being struck by an object, medical malpractice by health care providers also can cause serious and fatal brain injuries.

Examples of Doctor Negligence Causing Brain Injuries

Doctors and hospitals have a legal responsibility to deliver medical treatment according the recognized standard of care. When doctors fail to deliver the appropriate care, the impact to the patient receiving treatment can often be devastating.

Examples of doctor negligence that can lead to these types of brain injuries include:

  • Failure to order appropriate tests and diagnose
  • Improper diagnosis and treatment of any sort of concussion or head trauma
  • Anesthesia errors
  • Mistakes in medication dosage, including a failure to properly monitor pain pumps
  • Lack of proper ventilation or failure to follow safety procedures before, during, and after surgery, leading to infection
  • Surgical errors
  • Errors or delays made during labor and delivery that deprive the baby’s brain of oxygen
  • Inadequate monitoring during the birthing process and failure to respond quickly to signs of distress during the birth.
  • Improper treatment of pre-eclampsia, resulting in a seizure cutting off oxygen to the baby in utero
  • Failure to render treatment or aid to a patient having breathing difficulties or showing signs indicating respiratory distress
  • Failure to diagnose and treat signs of an aneurysm, arrhythmia, stroke, or heart attack in a timely fashion

Delays in Diagnosis and Treatment can Cause Long Lasting Effects

Even a seemingly insignificant delay in diagnosis or medical treatment can end up causing an individual to become deprived of adequate oxygen supply or experience abnormally low levels of oxygen in the body’s organs and tissue. Should this happen, hypoxic or anoxic brain injuries are likely to result. This is due to the fact that brain cells cannot survive without oxygen. It only takes about four or five minutes for brain cells to begin to die once deprived of oxygen. If hypoxia is allowed to continue for longer than a few minutes, it could lead to seizures, coma, and possibly brain death.

Once the brain has been deprived of oxygen, damage can be permanent. Recovery will depend on the extent of the damage caused, as well as the length of time the brain was either deprived of oxygen or was subjected to exceedingly low levels of oxygen. In many cases, recovering from a brain injury will be a long, grueling process. Others may not ever be able to return to the standard of living they once enjoyed.

Neither the doctor nor the hospital is likely to admit to a patient that they have made an error leading to a brain injury. If you have a loved one who you suspect suffered a brain injury caused by medical malpractice, you may not know what actually happened unless you consult a qualified medical malpractice attorney and have the patient’s medical records examined, to determine if doctors followed the appropriate standard of care.

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Guest post by Sansone & Lauber

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