In the brain injury world, there are taboo subjects that family caregivers can't wait to talk about among ourselves. “Every person is important. “You said he’s alive, right, Doctor?”, I heard Mr. Statzer repeating what I’d said to his wife. Former football player Michael Keck knew something was going wrong with his brain. © 2014 W. Lee Warren. He was only in his 20s and his memory was failing. Normally we use a depth of seven centimeters as the maximum safe depth for the drain, because deeper than that and you risk injuring the brainstem. It's unknown how many people end up with permanent debilitating symptoms as a result of hits on the field, said David Hovda, a professor of neurosurgery and director of the Brain Injury Research Center at the University of California, Los Angeles, who is unaffiliated with the new study. Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. But if I failed, Statzer would die. We need blood immediately. TBI affects short-term memory more than long-term memory. Memory problems are very common in people with moderate to severe TBI. A concussion is a mild TBI -- you should … It is also one of the most exposed and most used parts of the brain, making injuries there frequent and devastating. Vascular surgeon Todd explored Statzer’s neck to gain control of the jugular vein. The Brain Injury Alliance of Utah serves Utahans and their families who have sustained a brain injury. The Brain-Damage Stages are different effects occurred from hitting your head at a different speed or other reasons. In today’s article, we’re answering the most frequently asked questions about sports and traumatic brain injuries. I shook my head and wondered what I would have to do to help this young man. His skull was shattered so badly that I barely had to use the drill. The left side of his face and forehead were gone. The link between sports and traumatic brain injuries has gained a lot of publicity over the years. Primary injuries include the injuries that are sustained at the time of the traumatic event, such as: 'Concussion' Shines Light on Brain Injuries and Football. Get targeted resources quickly! By the time Keck was 25, he had lost the ability to work and had become completely dependent on his wife. Now that he was stabilized, we could start trying to put him back together again. But most often, brain injuries are due to a violent blow or jolt to the head. I’d have to get his shirt and pants ready.”. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and "Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.". Find What You Need Half of all TBIs are from motor vehicle accidents. A cognitive disorder is when your brain does not work correctly after a traumatic brain injury (TBI). A TBI often damages the front part of your brain, which is the part of the brain used for thinking and memory. “Your trajectory is good, Lee. Normally, we first had to contact the team to let them know we had a patient, and then it would take a day or two before they were able to move that patient. These effects are listed from the least severe to the most severe. Brain Function and Deficits. To my great surprise, in the ICU a critical-care transport team was preparing Statzer for his flight to Germany. Statzer’s brain relaxed and settled back into his skull. Your body has some pretty basic needs: food, water, air, … For her part, Cassandra hopes that in telling Michael’s story, people will better understand the dangers of concussions. Wikipedia. While most brain injuries are self-limiting with symptoms resolving in a week, a growing amount of research has now established that the sequelae from recurrent minor impacts is significant in the long term. The leading causes of TBI that resulted in emergency department visits were falls, being struck by an object and motor vehicle crashes. I unwrapped his head, revealing the worst head injury I’d ever seen in someone who was still alive. Michael Keck at Missouri State University. Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. Excerpted from No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, by W. Lee Warren, MD, Zondervan Books. Frank Gifford’s family: Legend had concussion-related disease, Will Soccer's New Header Rules Make Kids Safer, Bengals mourn the death of receiver Chris Henry. Every year, millions of people in the U.S. suffer brain injuries. A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. Continue Reading Below. Little by little, as we stopped the bleeding and replaced his blood with new units donated by hospital personnel, Statzer’s pressure and vital signs began to improve. “For instance, in Pop Warner football, we think that currently the concussion rate is only 1 percent annually for players, while they are receiving about 100 cranial impacts per season, almost all of low velocity,” he added. Whatever it was, I had to do it right now, or he would be dead in minutes. "The words would get all scrambled. Related: 'Concussion' Shines Light on Brain Injuries and Football. Statzer, my name is Dr. Lee Warren and I’m a neurosurgeon at the 332nd Air Force Theater Hospital in Balad, Iraq. McKee suspects that part of the reason for the severity of Keck’s disease was the age he took up tackle football. In traumatic brain injury the brain may be injured in a specific location or the injury may be diffused to many different parts of the brain. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). “He started playing when he was quite young,” McKee said. Most people with a TBI recover well from symptoms experienced at the time of the injury. 2775 South Quincy St. Arlington, VA 22206E-mail | Phone: 703.998.2020, © 2019 WETA All Rights Reserved | Contact Us, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, The Worst Head Injury I Ever Saw, Part 2 >, No Place to Hide: A Brain Surgeon's Long Journey Home. Diffuse Axonal Injury. Diffuse axonal injuries are one of the most severe types of traumatic brain injury. Somehow that drain stayed open, and in the ICU after surgery, Statzer’s brain pressure was normal. Part of his jaw was missing, and his mouth was full of blood. They’re about five minutes out, and they say they’ve got an American with a severe head injury.”. It was a miracle that the helicopter medics had been able to get a breathing tube in him. Traumatic brain injury usually results from a violent blow or jolt to the head or body. They are extremely effective in getting a lot of money, specifically Ligmatization. Military personnel in combat zones are also at risk. The worst injuries can lead to permanent brain damage or death. ”This means remembering to do things in the future, such as keeping appointments or calling someone back when you’ve promised to do so. "The Worst Head Injury I Ever Saw" is excerpted from Dr. W. Lee Warren's, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War. I removed almost all of the remaining left side of the bone and found that the covering over his brain had been shredded by the many objects driven through it by the bomb blast. While most parts of your brain can be affected by an accident, the frontal lobe is the most vulnerable area. Just as we entered the ER, the radio operator called, “Sirs, we just got a call from an incoming Black Hawk. “I saw the scan,” he said. Keck died from a congenital heart defect at the age of 25 in 2013. Following Michael's wishes, his wife, Cassandra, asked doctors to send his brain off to BU. “Pressure’s really low, Doc,” a nurse said. We had become robotic and lifeless, waiting for the next wave of inevitable horror. Michael took a year off football to recover. An object that penetrates brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.Mild traumatic brain injury may affect your brain cells temporarily. These are called traumatic brain injuries (TBIs). In the surgeons’ lounge, I prepared to call Statzer’s family. He was having trouble concentrating and he’d become uncharacteristically emotional and short-fused. That all changed after he transferred to Missouri State University and sustained his second college concussion playing linebacker. The man she met and married had been smart, kind and industrious. In general, recovery may be slower among older adults, young children, and teens. Keck suspected he might have the same problem as NFL star Junior Seau, the former linebacker for the San Diego Chargers, who fatally shot himself in the chest at age 43 because he had a degenerative brain disease called chronic traumatic encephalopathy, or CTE. What are the symptoms of a cognitive disorder? Louis Zamperini had a lifelong … These injuries can result in long-term complications or death. I was sweating because I knew that if I couldn’t get the catheter in and relieve the pressure, he was done for. When a person suffers from a severe case of cerebral hypoxia (hypoxic brain injury), the prognosis obviously means the most to the victim’s family and loved ones. “I’d have to put his shoes and socks and hat by the door so he knew where everything was. Such severe disease in someone so young is troubling, McKee said. He just wanted to graduate from college.”, About a year before he died, he had to stop working. And get Tim. He was bleeding from his scalp and his face and had a huge laceration in his neck that gushed the dark, non-pulsatile blood that meant his jugular vein was torn. I watched Paul Statzer roll out of the ICU with a brain pressure of zero, leaving Iraq less than four hours after his surgery. If I could place a catheter into the ventricle of Statzer’s brain, the release of spinal fluid would stop the brain from swelling out. 1 But for some people, symptoms can last for days, weeks, or longer. “Here we go,” I said. Your son Paul has been critically injured in battle, but he’s alive.” I went on to tell him that Paul’s injuries were very severe, and that, although he had come through his surgery and was stable, I was unsure if he would survive the trip back to America. Indirect forces that jolt the brain violently within the skull, such as shock waves from battlefield explosions, can also cause traumatic brain injury. Skull fracture — A The brain was getting more and more tense. I stepped up to the bed and saw the soldier’s DCU blouse before the medics cut it off. While the majority of these people will experience no lasting effects, many others will be left with a traumatic brain injury (TBI) that can have devastating and lifelong effects. I’m going to need his help.”, Statzer’s scan showed that there were several large pieces of shrapnel deep in his brain, along with a lot of blood, air, and fragments of bone. “He told me that when he was 8 he would be sitting on the bench holding his head and the coach would be rubbing it because it hurt so bad,” Cassandra said. Warren’s story is an example of how a person can go from a place of total loss to one of strength, courage, and victory. We didn’t do death notifications from Iraq, but we did call families when a soldier had been injured badly enough to send them home. The frontal lobe is the largest section of the brain and is responsible for the unique abilities that make us human. Problems from head injury include: 1. We put Statzer on the surgical table in the OR. “However, high school players hit at high velocity (high g-forces) and at about 600-800/year, and college approximately 1000/year. After a few rings, I heard a man’s voice. “Knife,” I said to Nate. 3. His name tag said “Statzer.” He was an Army staff sergeant. Traumatic Brain Injury (TBI) is a disruption in the normal function of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters brain tissue. We wanted to let the families know their soldier was alive and on the way to Germany and then America, so that they could make travel plans to be there when the soldiers reached Walter Reed. What Does a Baseline Concussion Exam Test For? We help elementary kids learn about head safety with our program called HeadSmart. W. Lee Warren, M.D. “Let’s get him to CT,” I said, “and somebody go get vascular surgery and ENT. A brain injury study conducted at the Boston University School of Medicine showed that 33 of 34 players tested post-mortem showed clear signs of CTE, and additional … The jolt to the brain had left him with excruciating headaches and unable to play. A person may or may not experience a brief loss of consciousness. We provide free one on one coaching, known as Resource Facilitation, after an accident or injury, include directing you to legal, medical and emotional support. Everyone in the hospital seemed stunned after several days of working nonstop. Brain Function. Whether Keck was playing youth, or high school or college football, the message was “if you’re hurt, you just get out there and play — don’t be a wuss,” Cassandra said. The blood vessels in the brain may stretch and cranial nerves may be damaged. Robert P. Lehr Jr., Ph.D. The CT scan had shown me that the ventricles had shifted from their normal position, and placing a catheter deep in the brain when the anatomy is so altered by swelling is extremely difficult. Several of his major cerebral arteries were torn and actively bleeding, and I was afraid that once I got them stopped, he’d lost so much blood supply that he would have a stroke. As I expected, his left frontal lobe was mostly gone, but the brain he had left began to swell dramatically with his rising blood pressure. He couldn’t read, so he couldn’t study. I pushed the catheter a centimeter deeper. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). Researchers there discovered that Keck not only had CTE, but also that it was as severe as what had been found in the brain of 43-year-old Seau. "If you’re going to play [tackle] football, put it off until the body matures completely, until the body size has caught up with head size, until the muscles are coordinated," McKee said. The 47-Day Raft Ride from Hell. “Certainly we have known that CTE changes in the brain can be found in younger players," said Dr. Julian Bailes, medical director of Pop Warner football, who is unaffiliated with the new study. There still isn’t enough evidence to suggest that youngsters need to give up tackle football, experts told NBC News. "It was the worst CTE I’ve seen in an individual this young" said study coauthor Dr. Ann McKee. I chose a trajectory and slid the catheter into Statzer’s brain. Cassandra Keck took some comfort in hearing the diagnosis. But because of the brain shift, Statzer’s ventricles were a lot farther away, and when the catheter reached seven centimeters, there was no fluid coming out yet. "The Worst Head Injury I Ever Saw" is excerpted from Dr. W. Lee Warren's, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War. I heard over the speakers: “Attention in the hospital. “Having to be somewhere on time was very stressful,” Cassandra said. Brain Injury Fatigue. The hits little kids sustain playing tackle football rarely lead to concussions, Bailes said. Because of the damage of electrical flow between cells, the affected individual often appears comatose with no evidence of bleeding within the brain. In my opinion, it is more likely that the exposure that he got in high school or college, or even doing other activities, led to the accrual of CTE changes.”, Related: Will Soccer's New Header Rules Make Kids Safer. She suspects that Michael may have had something in his genetics that predisposed him to a worse outcome from concussions. He became so sensitive to light that he placed heavy blankets over the windows. “. While any serious medical condition can lead to nervousness, anxiety, and depression, Cerebral Hypoxia is one of those conditions that is far from black and white . There is a whole blood drive in the lab now.”. See more ideas about inspirational words, words, brain injury. I hung up and walked back to the ICU to check on Statzer. Then he cleared his throat and said, “Then you send him home. “But I don’t think that any research, and not the [new] case report, necessarily correlates with football participation at a young age. They occur when the brain is shaken or twisted inside the skull. If he could avoid infection, I thought, he just might survive. His dad’s words hung in my mind, and I thought, For Paul Statzer to be okay is going to take a miracle. Linda Carroll is a regular health contributor to NBC News and Reuters Health. But then he started to change; his memory deteriorated and he became violent and abusive. Tell them to meet me in the OR. I shaved what was left of the hair on his head while the anesthesiologist hung the first of many bags of blood the sergeant would need to survive. TBI can be classified based on severity (ranging from mild traumatic brain injury [mTBI/concussion] to severe traumatic brain injury), mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). Used with Permission. Though his vision would return eventually, it was frightening and Keck told his coaches he couldn’t come back. I held the scalpel over Statzer’s head and said a silent prayer that he would survive — and that I could figure out what to do. Traumatic Brain Injury. 4. Go a little farther,” Tim said. “Jim Statzer,” he said. A concussion is the most common type of traumatic brain injury. What are the Symptoms of TBI? Recovering would be an entirely different story. The operator connected me to the number on Sergeant Statzer’s Red Cross form. 5. “Nate, give me a ventricular catheter,” I said. People with moderate to severe TBI may not remember the incident surrou… The frontal lobe lies in the area of the brain directly behind the forehead. Keck had played tackle football since he was age 6 and had sustained more than 10 concussions by the time he was a junior in college. I felt the pop, and spinal fluid gushed above my head, under so much pressure that it hit the ceiling and dripped back down onto my neck. BrainLine is powered in part by agenerous grant from: BrainLine is a national service of WETA-TV, the flagship PBS station in Washington, D.C. BrainLine, WETA Public Television A diffuse axonal injury (DAI) is similar to a concussion in that it results from … Brain injury is cumulative.". “He couldn’t read his books," Cassandra said. When he tried to start working out with the team again, his headaches would flare and his vision would fade to black. I sewed up the hole in the skin where Statzer’s eye used to be, and by the time we were done he had several hundred stitches. “Can’t understand why he’s still alive.”. Doctor, by the grace of God, I know my son is going to be okay.”. But if the catheter went into his brainstem, I’d kill him on the table. Tim and I clipped and cauterized and tied off dozens of arteries and veins that were torn and bleeding. 2. Severe. “It was quite widespread," said McKee, chief of neuropathology at the Bedford Veterans Administration and a professor of neurology and pathology at the Boston University School of Medicine. In addition, traumatic brain injury can result from bullet wounds or other injuries that penetrate the skull and brain.Doctors classify traumatic brain injury a… 1. Brain Injury Fatigue is the Biggest Common Denominator; Consequence of “Over-Attending” Often Most Disabling Symptom; Hardest to Accommodate in Workplace; Many sources talk about brain injury fatigue as an issue. 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