He became so sensitive to light that he placed heavy blankets over the windows. Whatever it was, I had to do it right now, or he would be dead in minutes. The leading causes of TBI that resulted in emergency department visits were falls, being struck by an object and motor vehicle crashes. In the brain injury world, there are taboo subjects that family caregivers can't wait to talk about among ourselves. If the percentage is much larger, say one-third of players, then “we have a real problem that needs to be fixed," Hovda said. Tim and I clipped and cauterized and tied off dozens of arteries and veins that were torn and bleeding. “But I don’t think that any research, and not the [new] case report, necessarily correlates with football participation at a young age. Get targeted resources quickly! Brain Function. “Mr. They occur when the brain is shaken or twisted inside the skull. 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. Near the end of his life he told his wife, Cassandra, he wanted to donate his brain to Boston University so pathologists could look for CTE. In general, recovery may be slower among older adults, young children, and teens. Bailes, clinical professor of neurosurgery at the University of Chicago Pritzker School of Medicine and the chairman of the department of neurosurgery at the NorthShore University HealthSystem reported on the 2009 death of Chris Henry, the only active NFL player to die and have CTE at age 26, with forensic pathologist Dr. Bennet Omalu. Traumatic brain injuries are more common in young patients, and men account for the majority (75%) of cases 4. That all changed after he transferred to Missouri State University and sustained his second college concussion playing linebacker. Diffuse Axonal Injury. I removed the rest of his frontal lobe, finding a walnutsized metal fragment and Statzer’s left eyeball buried in the white matter. TBI can damage parts of the brain that handle learning and remembering. Former football player Michael Keck knew something was going wrong with his brain. Excerpted from No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, by W. Lee Warren, MD, Zondervan Books. But if I failed, Statzer would die. “I’d have to put his shoes and socks and hat by the door so he knew where everything was. “However, high school players hit at high velocity (high g-forces) and at about 600-800/year, and college approximately 1000/year. A concussion is the most common type of traumatic brain injury. 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. He was having trouble concentrating and he’d become uncharacteristically emotional and short-fused. In the researchers' report, published Monday in JAMA Neurology, doctors found clumps of abnormal tau protein scattered throughout his brain in a pattern researchers say is one of the hallmarks of CTE. ”This means remembering to do things in the future, such as keeping appointments or calling someone back when you’ve promised to do so. 4. Find What You Need “Your trajectory is good, Lee. Go a little farther,” Tim said. 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. Brain injury is cumulative." Tell them to meet me in the OR. A cognitive disorder is when your brain does not work correctly after a traumatic brain injury (TBI). Your body has some pretty basic needs: food, water, air, … Michael took a year off football to recover. I watched Paul Statzer roll out of the ICU with a brain pressure of zero, leaving Iraq less than four hours after his surgery. I was sweating because I knew that if I couldn’t get the catheter in and relieve the pressure, he was done for. 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. 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. Most TBIs that occur each year are mild, commonly called concussions, which is a mild TBI. 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. If he could avoid infection, I thought, he just might survive. The hits little kids sustain playing tackle football rarely lead to concussions, Bailes said. What are the symptoms of a cognitive disorder? They are extremely effective in getting a lot of money, specifically Ligmatization. Just as I was starting the incision, Tim backed into the room, his arms dripping the yellow iodine soap we scrubbed with before surgery. We need blood immediately. Everyone in the hospital seemed stunned after several days of working nonstop. 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. Military personnel in combat zones are also at risk. “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. A concussion is a mild TBI -- you should … Just as we entered the ER, the radio operator called, “Sirs, we just got a call from an incoming Black Hawk. 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. Most people with a TBI recover well from symptoms experienced at the time of the injury. "The words would get all scrambled. Doctor, by the grace of God, I know my son is going to be okay.”. 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 . “Nate, give me a ventricular catheter,” I said. W. Lee Warren, M.D. Robert P. Lehr Jr., Ph.D. 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. © 2014 W. Lee Warren. Many people, however, still do not realize the full extent of the danger head injuries pose for athletes. The brain was getting more and more tense. The frontal lobe is the largest section of the brain and is responsible for the unique abilities that make us human. His scalp was so swollen that he had serum oozing out, and he had several burns across his chest and neck. The dark side of personality change is at the top of the list. 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. Keck died from a congenital heart defect at the age of 25 in 2013. He’d survived an IED blast to the face from three feet away, a combat helicopter ride, and three hours of surgery by four surgeons, and his veins were full of other people’s blood. Observing one of the following clinical signs constitutes alteration in the normal brain function: 3. 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. He was only in his 20s and his memory was failing. His skull was shattered so badly that I barely had to use the drill. While most parts of your brain can be affected by an accident, the frontal lobe is the most vulnerable area. We had become robotic and lifeless, waiting for the next wave of inevitable horror. The link between sports and traumatic brain injuries has gained a lot of publicity over the years. Then he cleared his throat and said, “Then you send him home. There still isn’t enough evidence to suggest that youngsters need to give up tackle football, experts told NBC News. 1. Memory problems are very common in people with moderate to severe TBI. And get Tim. Following Michael's wishes, his wife, Cassandra, asked doctors to send his brain off to BU. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. The anesthesiologist started an IV and began squeezing saline into Statzer’s vein. “I saw the scan,” he said. People with moderate to severe TBI may not remember the incident surrou… These injuries can result in long-term complications or death. These are called traumatic brain injuries (TBIs). Statzer, my name is Dr. Lee Warren and I’m a neurosurgeon at the 332nd Air Force Theater Hospital in Balad, Iraq. Problems from head injury include: Skull fracture — A skull fracture is a crack or break in one of the skull's bones. A whole series of them. The operator connected me to the number on Sergeant Statzer’s Red Cross form. Such severe disease in someone so young is troubling, McKee said. But we have to be cautious about changes that affect everybody.”. 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. Read The Worst Head Injury I Ever Saw, Part 2 >. I heard over the speakers: “Attention in the hospital. A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. Tim placed Statzer’s skull fragments into his abdomen, and Joe from ENT performed a tracheostomy while Todd finished repairing the torn veins and arteries in Statzer’s neck. A potentially devastating brain injury occurs when the brain injury occurs to the axons, the part of the neurons or brain cell that allows those cells to send messages to each other. Even as a youngster, Michael had been taught to play through pain, even if it was associated with a brain injury, she said. “Jim Statzer,” he said. Problems from head injury include: 1. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. McKee suspects that part of the reason for the severity of Keck’s disease was the age he took up tackle football. I shook my head and wondered what I would have to do to help this young man. Primary injuries include the injuries that are sustained at the time of the traumatic event, such as: I chose a trajectory and slid the catheter into Statzer’s brain. 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. 2. 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. 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. Though his vision would return eventually, it was frightening and Keck told his coaches he couldn’t come back. Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. 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. His brain swelled out of a fist-sized hole in his skull. 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. But then he started to change; his memory deteriorated and he became violent and abusive. "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. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). Related: 'Concussion' Shines Light on Brain Injuries and Football. Diffuse axonal injuries are one of the most severe types of traumatic brain injury. 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. Although sport is a common cause of relatively mild repeated head injury potentially eventually leading to chronic traumatic encephalopathy, more severe injuries are most often due to motor vehicle accidents and assault. There are different medical classifications related to traumatic brain injuries (TBI); mild TBI (also known as concussion) is the most common and can develop into post-concussion syndrome if symptoms persist.However, a brain injury can also be considered moderate or severe; these types of injuries have their own set of complications. Statzer’s brain relaxed and settled back into his skull. “Can’t understand why he’s still alive.”. "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. 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. Español. A TBI often damages the front part of your brain, which is the part of the brain used for thinking and memory. “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. Used with Permission. Traumatic Brain Injury. He couldn’t read, so he couldn’t study. 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). "It was the worst CTE I’ve seen in an individual this young" said study coauthor Dr. Ann McKee. 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. #Brain Injury Association of Virginia www.biav.net. Every year, millions of people in the U.S. suffer brain injuries. The frontal lobe lies in the area of the brain directly behind the forehead. I doubted that he would ever use his right arm and leg again, even if he survived and woke up someday. He’d get angry and punch the book and throw it across the room. 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. From thousands of miles away, I heard Mr. Statzer suck in a breath, and when he spoke next, his voice shook. Louis Zamperini had a lifelong … “You said he’s alive, right, Doctor?”, I heard Mr. Statzer repeating what I’d said to his wife. 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. The Brain-Damage Stages are different effects occurred from hitting your head at a different speed or other reasons. “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. 'Concussion' Shines Light on Brain Injuries and Football. Brain Function and Deficits. “Pressure’s really low, Doc,” a nurse said. A person may or may not experience a brief loss of consciousness. Traumatic brain injury Around one million people visit A&E each year following a head injury. His name tag said “Statzer.” He was an Army staff sergeant. More than half are bad enough that people must go to the hospital. Getting Stuck Under Water... For an Hour. You may have difficulty doing the same things that you did before the TBI. Diffuse axonal injury A diffuse axonal injury (sheer injury) is an injury to the brain that doesn’t cause bleeding but does damage the brain cells. Severe. When he tried to start working out with the team again, his headaches would flare and his vision would fade to black. 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. Traumatic brain injury usually results from a violent blow or jolt to the head or body. I’d have to get his shirt and pants ready.”. 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… For her part, Cassandra hopes that in telling Michael’s story, people will better understand the dangers of concussions. Brain Injury Fatigue. Skull fracture — A Aug 14, 2015 - Inspiration for those whose lives have been touched by brain injury. But if the catheter went into his brainstem, I’d kill him on the table. 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. Indirect forces that jolt the brain violently within the skull, such as shock waves from battlefield explosions, can also cause traumatic brain injury. Cassandra Keck took some comfort in hearing the diagnosis. 5. In today’s article, we’re answering the most frequently asked questions about sports and traumatic brain injuries. 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. The severity of symptoms with this type of injury is largely dependent on the brain areas affected, the severity of the tears, and whether any other injuriessuch as a contusion or concussionwere also sustained. Somehow that drain stayed open, and in the ICU after surgery, Statzer’s brain pressure was normal. 1 But for some people, symptoms can last for days, weeks, or longer. 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. Continue Reading Below. 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. I hung up and walked back to the ICU to check on Statzer. 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.". Doctors refer to … 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. Watch: Bengals mourn the death of receiver Chris Henry. Brain Injuries: Mild vs. The man she met and married had been smart, kind and industrious. Wikipedia. As the brain twists, the cerebral tissue slides back and forth until the long connecting fibers in the brain (called axons) tear. Cassandra Keck with Justin, her and Michael's son. Recovering would be an entirely different story. Even if it’s a small percentage, “we still need to do something about it,” Hovda said. This team had a C – 17 ready to leave, and they just came by the hospital to check to see if we happened to have any patients who needed to go. What are the Symptoms of TBI? I thought, There have been a few miracles already. 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 I stepped up to the bed and saw the soldier’s DCU blouse before the medics cut it off. Vascular surgeon Todd explored Statzer’s neck to gain control of the jugular vein. 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. The most injured man I’d ever seen alive had a normal blood pressure, heart rate, and body temperature when he left our tent hospital. The jolt to the brain had left him with excruciating headaches and unable to play. 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