Posted on 12th April 2010 by gjohnson in Uncategorized
"Grey's Anatomy", Afghanistan, explosive, Mild Traumatic Brain Injury, Traumatic Brain Injury
Sometimes the truth is just as strange as fiction.
The medical drama Grey’s Anatomy had a two-part episode several years ago about surgeons having to extract an unexploded bomb from a man’s chest.
U.S. military surgeons in Afghanistan recently had to perform a similar task: Removing an undetonated explosive from a man’s head. http://www.nytimes.com/2010/04/10/world/asia/10military.html?src=me&ref=general
The patient, a 20-year-old Afghan soldier, came in for treatment at the emergency room of Bagram Air Base hospital with what appeared to be a piece of shrapnel in his scalp.
A CAT scan showed that the object was about 2 ½ inches long.
But then radiologist Lt. Col. Anthony Terreri took a closer look at the CAT-scan, and realized that the object was actually an explosive device. http://www.nypost.com/p/news/international/docs_pull_explosive_from_soldier_1wgRTWjAH6RExn3pjsOCIM
That’s when the army doctors cleared out any unnecessary personnel out of the operating room and summoned the explosive disposal team.
The surgeons had to operate wearing full-body armor, with the bomb squad nearby. According to The New York Times, the electronic monitoring devices in the operating room were turned off, so they wouldn’t accidentally detonate the explosive. So the surgical staff used manual blood pressure monitors and a battery-powered heart monitor.
Trauma surgeon Major John Bini and anesthesiologist Major Jeffrey Rengel went to work. Bini cut through scalp tissue, cut around the explosive, which was under a patch of skull bone, according to The Times.
It took Bini 10 minutes to get the device out and hand it over to the bomb squad.
The Times reported that the patient, a National Afghan Army soldier who wasn’t identified, has been discharged from the hospital and is recovering.
The man sustained brain injury from bone fragments, but could walk, talk and eat, according to The Times. But The New York Post reported that the man sustained traumatic brain injury from the surgical procedure.
Posted on 13th January 2010 by gjohnson in Uncategorized
Brain injury, brain injury attorney, brain injury lawyer, Concussion, Concussion and Sport Guidelines, Mild Traumatic Brain Injury, NFL brain injury
Continuing on with the discussion of my Concussion Clinic videos, today’s topic is Non-Athletes are at Far Greater Risk of Disability. Today’s video is here:
http://www.youtube.com/profile?user=braininjuryattorney#p/u/5/Z3QvSHrWykISport is an ideal laboratory to study concussion. First, almost all sport concussions get witnessed and in today’s world, most get videotaped. Second, a very significant percentage of them happen on university campuses where scientists and medical researchers are looking around for things to study. Three, they are predictable, happen in a confined space and to a subset of people who we can control. The predictability and control means we can actually study and test their cognitive abilities before they have the concussion. And then because we know they will have repeated concussions, we can study that as well.
The problem with sports as the laboratory is that we are studying those people who tell us the least about what might happen to average people who suffer accidental concussions. In the sport laboratory we are studying those people who are most likely to get better, to have an “apparent full recovery”. Thus, the sport and concussion literature has done an excellent job of dealing with the primary issue which they care about, determining when it is safe to expose our football players to another concussion. But the truly important issue, of what disability is likely to come from a concussion and how can we best diagnose and treat that disability, the sport laboratory tells us very little.
In fact, the dark side of neuropsychology is trying to use sports concussion research as evidence that concussion does not cause permanent damage. Anyone who has worked with Post Concussion Syndrome survivors knows that concussion or mild traumatic brain injury, can disable. The young male athlete’s apparent full recovery does not tell us very much about how someone older, someone not in extraordinary shape, someone who was not expecting to get hit, will recover.
Here is the reality of the real world of concussions: If you are significant at 24 hours, and you are female and you are over 40, you need to go see the doctor every couple of days until you get better. You need to see a doctor who is going to test your memory. You need a doctor who is not just to test your memory for things you know about your life, but what you have been doing in the 24 hours before that examination. And you need a doctor who is not going to just ask you those questions, but also ask the people you live with.
Obviously, disability happens to those who are not 40, not female, but the more vulnerable your brain is because of age, because of prior concussions, because of emotional challengers you have had in your life, the more likely you will have a bad result. If you are at risk for a bad result, you must be followed and diagnosed in that first week. If you don’t get that type of evaluation we will have no way of predicting whether this concussion will give you a few bad days, a few bad weeks or keep you disabled the rest of your life.
