Polar Bear’s Sudden Death Blamed On Undiagnosed Brain Damage

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Posted on 3rd April 2011 by gjohnson in Uncategorized

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Animal lovers were shook up over the sudden death last month of Knut, the polar bear who resided in the Berlin Zoo. As it turns out, it appears that Knut died from undetected brain damage, according to a report on AsiaOne.com.

 http://news.asiaone.com/News/AsiaOne%2BNews/World/Story/A1Story20110322-269501.html

Knut was only four years old when he was found dead in a pool at the zoo. He had become world famous for his playful antics when he was a cub. He was reared by humans after his mother abandoned him.

Following his demise, the Berlin Zoo put out a press release that said a necropsy found “significant changes to the brain, which could be seen as the reason for the sudden death of the polar bear.”

It’s  a shame that ”cute Knut,” as he was nicknamed, met this end.

Once he grew into an adult, animal-rights groups expressed fear that Knut was behaving oddly because of all the attention he garnered from the visitors that flocked to the zoo to see him.

“He would sway to and fro and even imitate people taking photos by lifting a paw to his face,” AsiaOne reported.

I guess those animal-rights groups were right to be worried about Knut.

   

Using Neuroscience To Explain A Linebacker’s Subtle Brain Injury

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Posted on 23rd August 2010 by gjohnson in Uncategorized

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In a well-done story, Discover Magazine describes in clear, concise detail the consequences of  our brains getting repeatedly banged around. The article is headlined “The Brain: What Happens To A Linebackers Neurons?”

http://discovermagazine.com/2010/jul-aug/18-brain-what-happens-to-a-linebackers-neurons

The piece opens by describing the new battery of cognitive tests that the National Football League gives to players in the college draft, brainteasers such as trying to remember where different “Xs” and “Os” were positioned a page. 

The idea is to have a baseline to compare to a player’s answers after they sustain a head injury. If a player gets a concussion in a future game, he can be retested to compare his pre-concussion answers to his post-concussion ones, to gauge how badly his brain was injured. 

As our brains float around in the cerebrospinal fluid in our skulls, they get knocked around quite a bit. So how do our brains usually escape getting damaged?   

Discover Magazine illustrates that by citing research by Douglas Smith, director of the Center for Brain Injury and Repair at the University of Pennsylvania. We won’t go into all the detail, but Smith set up rat neurons on a stretchable membrane, and they developed axons, appendages that connect one neuron to another, transmitting electric signals.

When Smith directed a “controlled puff of air’” at  his “brain,” the axons were elastic and stretched, then went back to their old position.  But if he subjected his “brain” to a quick, big shot of air, the axons developed “kinks,” according to Discover Magazine. They wind up permanently damaged.

This type of damage can lead to diffuse axonal injury, which is when proteins “pile up”  on an axon, and can even burst it, Discover Magazine said. Diffuse axonal injury happens when a person’s brain is suddenly acclerated, as when someone gets whiplash.

This is apparently what happened to New York Mets outfielder Jason Bay recently. He crashed into a wall to catch a fly ball, and hurt his back and legs. He never hit his head, so a concussion was ruled out. But two days later Bay came down with a nagging headache. Team doctors now believe that Bay sustained a concussion from whiplash, from his head snapping back when he hit the wall. 

The type of mild brain injury that football players sustain again and again over the years has a cumulative effect, and the repeated stretching that axons undergo can essentially kill them “like a shorted-out circuit,” according to Discover Magazine.

There is some hope of finding drugs that can stop brain damage on the molecular level.

But at the present time, “Once a person does sustain a brain injury, there is not a lot doctors can do,” the magazine article says.  And that is the sad truth at the moment.  

Evolution in the Understanding of Concussion: Distinguish Between Confusion and Amnesia in Diagnosing Concussion

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Posted on 11th January 2010 by gjohnson in Uncategorized

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Continuing on with the topic “The Evolution of Our Understanding of Concussion, Otherwise Called Mild Traumatic Brain Injury,” our next point of emphasis is the importance of distinguishing between confusion and amnesia after a brain injury. The video on this topic is at: http://www.youtube.com/profile?user=braininjuryattorney#p/u/6/xuO69e9Vv_c

You can have significant amnesia and not be confused. How do we know that? On this specific issue, the sports arena is the ideal laboratory – NFL quarterbacks the perfect test subject. We know from hundreds of reported cases that a football player can finish the game, a quarterback can finish the game, and have no memory for the game when asked about it later. Thus, we know they were amnestic.

We also know that they were not confused while they were playing the game because football, especially quarterbacking, is not something someone can do while confused. Think of all the sequential, memory and processing intensive things an NFL quarterback must do on every single play. If he were confused, he wouldn’t survive a single play. While one can argue that a boxer can fight on auto-pilot, a quarterback cannot. A quarterback must remember the plays and make differential decisions under high stress, with instant processing.

The reason I make this point over and over is that in the vast majority of cases, the inquiry at the scene, in the Emergency Room is an inquiry only to determine whether a person is confused. If a person is not confused, they are presumed not to have suffered a brain injury. If the inquiry does not include a test for amnesia as well as confusion, then the diagnosis of brain injury will likely be missed.

The diagnostician, be it an EMT, an ER doctor or primary care doctor must put on the sports writer hat and ask about the events since the injury, not just about what happened before the injury or what is happening now. What we want to know about is what happened “during the game” – the period of time between the concussion and now. Tell me about the ambulance ride. Tell me about who else was in the Emergency Room.

And doctors, don’t be in such a hurry to decide there was no concussion. Amnesia often materializes in the hours after an accident – not the minutes – because brain injury is a process, not an event. For more on that topic, see the general treatment of that topic found on my website http://subtlebraininjury.com/ and the specific treatment at http://subtlebraininjury.com/tbiprocess1.html

At times the world of sport is a useful laboratory for us to learn about concussion, such as with this issue, but we must remember that the average person with an accidental concussion, is not an extraordinary physical specimen, who expected to get hit. More on the distinction between real world brain injury and sport concussions on my Brain Damage Blog, http://tbilaw.com/blog

The Evolution of Our Understanding of Concussion, otherwise Called Mild Traumatic Brain Injury

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Posted on 4th January 2010 by gjohnson in Uncategorized

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I have been blogging over the holidays about concussions because once again they have been in the news. As discussed on this blog, Texas Tech coach Mike Leach was fired because of his forced isolation of wide receiver Adam James after he was diagnosed with a concussion. See also my comment on a related issue on one of my Brain Injury Lawyer Blog: http://www.waiting.com/blog/

With these stories bringing concussion back in the headlines, it seems appropriate to spend the next several blogs discussing the evolution of how our medical community has viewed concussion. Prior to about 1990, there was almost universal ignorance in the medical community about concussion. Most textbooks and learned treatises which neurologists, emergency room doctors and medical students relied on, simply had it wrong. Among the most significant mistakes was the belief that an individual had to be unconscious to have suffered a brain injury. That significantly began to change with the publication of a definition of mild traumatic brain injury in 1992 by the American Congress of Rehabilitation Medicine. (Definition of Mild Traumatic Brain Injury, Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. J Head Trauma Rehabil 1993:8(3):86-87)

That definition is found at http://tbilaw.com/RehabDefinitionPage.php

To understand where we need to go with continuing improvement in the diagnosis of brain injury, I think it is important that we understand where we have come from. Thus, I created a series of lectures on this topic, found on my YouTube page http://www.youtube.com/profile?user=braininjuryattorney#p/u. The first of those lectures can be found at:
http://www.youtube.com/profile?user=braininjuryattorney#p/u/13/x2EKaVHpVd0

In this series of blogs, I will discuss the topics of each of those videos.

Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
http://subtlebraininjury.com
http://car-accident-rain.com
http://tbilaw.com
http://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447

Bad time to be rich? Only if you don’t like taxes

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Posted on 20th July 2009 by gjohnson in Uncategorized

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Wow, the Obama tax promise rubber hits the road. $440,000 tax increase on a $5 million income. Sounds awful but that is actually less than a 9% increase in marginal rate. When I first started to study the law, the marginal rate on the top tax bracket was 70%. What the article doesn’t say as to what the total taxes on that $5 million will be. I bet there is still enough money left over to buy designer labels and pay the mortgage payment.

A $30,000 increase on an $800,000 income sounds about right and sounds almost exactly what Obama promised.

Attorney Gordon Johnson
http://tbilaw.com
http://fishtail.tv
http://waiting.com


Date: 7/20/2009 12:03 AM

STEPHEN OHLEMACHER,Associated Press Writer


WASHINGTON (AP) — It’s probably never a bad time to be rich. But the good times for America’s wealthy could soon be a little less so.

President Barack Obama wants to boost income taxes for the wealthy to pay for tax cuts for everybody else. He wants to limit the deductions that high-income families take for mortgage interest and charity contributions to help pay for providing more people with health insurance.

House Democrats are planning to hit the wealthy with even higher income taxes to pay for their version of a health care overhaul.

Between the two plans, a family of four with an income of $5 million a year would see its annual income taxes skyrocket by more than $440,000. A similar family making $800,000 a year would get a tax increase of $30,000, according to an analysis by the financial services firm Deloitte Tax.

“I still think being wealthy is better than being poor,” Clint Stretch, who heads tax policy at Deloitte Tax, said with a touch of understatement. “But this is a pretty high proposed tax burden.”

Taxing the rich to pay for health insurance would represent a significant departure from the way Americans have financed safety net programs in the past.

Both Social Security and Medicare are supported by broad based payroll taxes. Although the rich pay more — they have bigger incomes — the burden is shared by the middle class and even the working poor.

By contrast, the health care plan working its way through the House would impose $544 billion in new taxes over the next decade on just 1.2 percent of households — joint filers making more than $350,000 a year.

The bill would impose a new 5.4 percent income surtax on couples making more than $1 million a year, starting in 2011. Couples making more than $350,000 would have to pay a surtax of 1 percent tax and those making more than $500,000 would pay a 1.5 percent surtax.

If certain savings in the health care system are not achieved by 2013, the surtax would rise to 2 percent for families making more than $350,000 and to 3 percent for those making more than $500,000.

For a family of four making $450,000 a year, the initial tax increase would be $1,000, according to the Deloitte analysis. But for the super rich, like a single filer making $5 million a year, the tax increase would be $452,000. The analysis assumes a typical mix of earned income, capital gains and itemized deductions for each income level.

Democrats said that for most of the affected taxpayers, the surtax would be far smaller.

“What we’re talking about is frankly very, very small amounts for the overwhelming majority of people who will pay it,” said Rep. Artur Davis, D-Ala.

The top marginal income tax rate now is 35 percent, on income above $372,950. Obama wants to boost the top rate to 39.6 percent in 2011 by allowing some of the tax cuts enacted under former President George W. Bush to expire.

The House Democrats’ proposed health care surtax would increase the top rate to 45 percent, making it the highest top rate since 1986, when it was 50 percent.

Republicans complain that some taxpayers would face marginal tax rates above 50 percent, when federal and state taxes are combined. They also say that tax increases on the wealthy hurt small business owners who typically pay their business taxes on their individual returns.

Democrats say the tax increases would affect only 4.1 percent of tax filers who report small business income. Those small businesses, however, tend to be the ones that employ the most workers, according to data from the National Federation of Independent Business.

“We shouldn’t have to resurrect the 1970s to remember that when tax rates go too high, people lose the incentive to build new businesses and create jobs,” said Rep. Wally Herger, R-Calif. “These massive tax increases are no substitute for real fiscal responsibility.”

Obama has tried to make the rich a popular target for tax increases as Democrats struggle to find ways to pay for his plan, intended to assure that virtually everyone gets health care. He regularly portrays the wealthy as big winners under Bush, noting that their taxes dropped and incomes soared during Bush’s eight years in office.

“I think the best way to fund (health care) is for people like myself who have been very lucky, to pay a little bit more,” Obama said recently.

The argument, however, omits the fact that Bush also cut taxes for middle- and low-income people. Their incomes didn’t jump as much as they did for the wealthy, but effective federal tax rates for middle-income and low-wage workers are at or near 30-year lows.

This year, 47 percent of filers won’t owe any federal income taxes — including some families making as much as $50,000 a year, according to separate projections by the Tax Policy Center and Deloitte Tax.

“Right now, if you are middle class or below, you are not expected to help pay to solve these problems,” said Stretch, the tax policy adviser.

Copyright 2009 The Associated Press.

Finally 60? Franken in Washington, says he’s ready to work

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Posted on 6th July 2009 by gjohnson in Uncategorized

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I had a minor in history, a major in journalism, graduated high in my law school class. But until George Bush won his second term in office, I didn’t know about the 51 means 60 rule in the U.S. Senate. From my perspective as a trial lawyer and consumer advocate, that 60 rule saved us in 2005, when the Republicans ran on a platform of what they called Tort Reform and would have legislated the civil justice system out of existence. For two years, until the Democrats regained control of the Senate, we advocates for consumer rights shuddered every time some Rush Limbaugh clone went on a rampage against basic rights that have been guaranteed going back to the Magna Carta.

Well, now it is the Democrats who have control of both Houses of Congress and the White House. Will they create some push back against the tort reform abuses of the Bush years? Probably not. But it sure is a lot better representing injured people when there are 60 members of the Democratic Party, than the other way around.

Attorney Gordon Johnson

http://tbilaw.com
http://fishtail.tv