Used with Permission. I heard over the speakers: “Attention in the hospital. I doubted that he would ever use his right arm and leg again, even if he survived and woke up someday. 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. I hung up and walked back to the ICU to check on Statzer. Traumatic brain injury Around one million people visit A&E each year following a head injury. He was only in his 20s and his memory was failing. His scalp was so swollen that he had serum oozing out, and he had several burns across his chest and neck. Former football player Michael Keck knew something was going wrong with his brain. The left side of his face and forehead were gone. 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. He was having trouble concentrating and he’d become uncharacteristically emotional and short-fused. But we have to be cautious about changes that affect everybody.”. 4. While most parts of your brain can be affected by an accident, the frontal lobe is the most vulnerable area. Traumatic brain injury usually results from a violent blow or jolt to the head or body. I unwrapped his head, revealing the worst head injury I’d ever seen in someone who was still alive. We help elementary kids learn about head safety with our program called HeadSmart. Getting Stuck Under Water... For an Hour. A person may or may not experience a brief loss of consciousness. W. Lee Warren, M.D. McKee suspects that part of the reason for the severity of Keck’s disease was the age he took up tackle football. I’d have to get his shirt and pants ready.”. But then he started to change; his memory deteriorated and he became violent and abusive. See more ideas about inspirational words, words, brain injury. 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. And get Tim. As the brain twists, the cerebral tissue slides back and forth until the long connecting fibers in the brain (called axons) tear. Skull fracture — A Most TBIs that occur each year are mild, commonly called concussions, which is a mild TBI. 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. What are the symptoms of a cognitive disorder? “Mr. Excerpted from No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, by W. Lee Warren, MD, Zondervan Books. 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. 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. Another question is whether head hits among some youngsters can be linked to CTE symptoms later in life. “Pressure’s really low, Doc,” a nurse said. “Nate, give me a ventricular catheter,” I said. 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. Indirect forces that jolt the brain violently within the skull, such as shock waves from battlefield explosions, can also cause traumatic brain injury. 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. These injuries can result in long-term complications or death. A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. 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. This area of the brain is responsible for reasoning, memory, concentrating, organizing, information processin… 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. A TBI often damages the front part of your brain, which is the part of the brain used for thinking and memory. By the time Keck was 25, he had lost the ability to work and had become completely dependent on his wife. She suspects that Michael may have had something in his genetics that predisposed him to a worse outcome from concussions. 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. 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. Read The Worst Head Injury I Ever Saw, Part 2 >. Though his vision would return eventually, it was frightening and Keck told his coaches he couldn’t come back. His dad’s words hung in my mind, and I thought, For Paul Statzer to be okay is going to take a miracle. That’s a lengthy exposure. It is also one of the most exposed and most used parts of the brain, making injuries there frequent and devastating. Even as a youngster, Michael had been taught to play through pain, even if it was associated with a brain injury, she said. A cognitive disorder is when your brain does not work correctly after a traumatic brain injury (TBI). Whatever it was, I had to do it right now, or he would be dead in minutes. Related: 'Concussion' Shines Light on Brain Injuries and Football. 1. His skull was shattered so badly that I barely had to use the drill. Traumatic Brain Injury. People with TBI may have a tough time “remembering to remember. The blood vessels in the brain may stretch and cranial nerves may be damaged. Traumatic brain injuries are more common in young patients, and men account for the majority (75%) of cases 4. “Your trajectory is good, Lee. Every year, millions of people in the U.S. suffer brain injuries. Diffuse Axonal Injury. 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. Wikipedia. Keck died from a congenital heart defect at the age of 25 in 2013. But if the catheter went into his brainstem, I’d kill him on the table. We put Statzer on the surgical table in the OR. “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. Following Michael's wishes, his wife, Cassandra, asked doctors to send his brain off to BU. But most often, brain injuries are due to a violent blow or jolt to the head. 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. In the surgeons’ lounge, I prepared to call Statzer’s family. Get targeted resources quickly! Military personnel in combat zones are also at risk. 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. Red, bleeding brain rushed out of Statzer’s head, and I again heard my old professor Dr. Baghai’s voice urging me to maintain control. “Can’t understand why he’s still alive.”. “He couldn’t read his books," Cassandra said. 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.". Brain Injury Fatigue. What Does a Baseline Concussion Exam Test For? More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. A whole series of them. Diffuse axonal injuries are one of the most severe types of traumatic brain injury. 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. “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. 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. These are called traumatic brain injuries (TBIs). You may have difficulty doing the same things that you did before the TBI. 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. 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. He’d get angry and punch the book and throw it across the room. #Brain Injury Association of Virginia www.biav.net. I stepped up to the bed and saw the soldier’s DCU blouse before the medics cut it off. 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. "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. The 47-Day Raft Ride from Hell. TBI affects short-term memory more than long-term memory. 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. Linda Carroll is a regular health contributor to NBC News and Reuters Health. He just wanted to graduate from college.”, About a year before he died, he had to stop working. 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. Tim and I clipped and cauterized and tied off dozens of arteries and veins that were torn and bleeding. 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). 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. “Here we go,” I said. They occur when the brain is shaken or twisted inside the skull. 3. 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. Half of all TBIs are from motor vehicle accidents. Find What You Need 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. 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. Just as we entered the ER, the radio operator called, “Sirs, we just got a call from an incoming Black Hawk. Everyone in the hospital seemed stunned after several days of working nonstop. 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. 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. 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. Many people, however, still do not realize the full extent of the danger head injuries pose for athletes. 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. 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. Just as I was starting the incision, Tim backed into the room, his arms dripping the yellow iodine soap we scrubbed with before surgery. The brain was getting more and more tense. Louis Zamperini had a lifelong … 5. Michael took a year off football to recover. 1 But for some people, symptoms can last for days, weeks, or longer. I pushed it to eight centimeters — still no fluid. “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. 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. “However, high school players hit at high velocity (high g-forces) and at about 600-800/year, and college approximately 1000/year. Severe. “Having to be somewhere on time was very stressful,” Cassandra said. "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. "The words would get all scrambled. 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. I pushed the catheter a centimeter deeper. Problems from head injury include: Skull fracture — A skull fracture is a crack or break in one of the skull's bones. Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. Continue Reading Below. Cassandra Keck took some comfort in hearing the diagnosis. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. But if I failed, Statzer would die. © 2014 W. Lee Warren. Problems from head injury include: 1. “So he had 16 years of football behind him. Brain Function. A diffuse axonal injury (DAI) is similar to a concussion in that it results from … “I saw the scan,” he said. I watched Paul Statzer roll out of the ICU with a brain pressure of zero, leaving Iraq less than four hours after his surgery. Doctor, by the grace of God, I know my son is going to be okay.”. They are extremely effective in getting a lot of money, specifically Ligmatization. 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. ”This means remembering to do things in the future, such as keeping appointments or calling someone back when you’ve promised to do so. Aug 14, 2015 - Inspiration for those whose lives have been touched by brain injury. After a few rings, I heard a man’s voice. In general, recovery may be slower among older adults, young children, and teens. Now that he was stabilized, we could start trying to put him back together again. “Let’s get him to CT,” I said, “and somebody go get vascular surgery and ENT. The Brain Injury Alliance of Utah serves Utahans and their families who have sustained a brain injury. That all changed after he transferred to Missouri State University and sustained his second college concussion playing linebacker. In today’s article, we’re answering the most frequently asked questions about sports and traumatic brain injuries. 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. Statzer’s brain relaxed and settled back into his skull. I thought, There have been a few miracles already. Primary injuries include the injuries that are sustained at the time of the traumatic event, such as: 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. 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. 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 … When he tried to start working out with the team again, his headaches would flare and his vision would fade to black. 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. "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. Memory problems are very common in people with moderate to severe TBI. Tell them to meet me in the OR. 'Concussion' Shines Light on Brain Injuries and Football. If he could avoid infection, I thought, he just might survive. 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 her part, Cassandra hopes that in telling Michael’s story, people will better understand the dangers of concussions. 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. Recovering would be an entirely different story. Go a little farther,” Tim said. Such severe disease in someone so young is troubling, McKee said. We need blood immediately. The frontal lobe is the largest section of the brain and is responsible for the unique abilities that make us human. From thousands of miles away, I heard Mr. Statzer suck in a breath, and when he spoke next, his voice shook. The hits little kids sustain playing tackle football rarely lead to concussions, Bailes said. Somehow that drain stayed open, and in the ICU after surgery, Statzer’s brain pressure was normal. Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. There is a whole blood drive in the lab now.”. Brain Function and Deficits. Even if it’s a small percentage, “we still need to do something about it,” Hovda said. 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. It was a miracle that the helicopter medics had been able to get a breathing tube in him. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). To my great surprise, in the ICU a critical-care transport team was preparing Statzer for his flight to Germany. 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 He became so sensitive to light that he placed heavy blankets over the windows. I shook my head and wondered what I would have to do to help this young man. Brain injury is cumulative." Observing one of the following clinical signs constitutes alteration in the normal brain function: 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. The dark side of personality change is at the top of the list. The link between sports and traumatic brain injuries has gained a lot of publicity over the years. I removed the rest of his frontal lobe, finding a walnutsized metal fragment and Statzer’s left eyeball buried in the white matter. 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 . “You said he’s alive, right, Doctor?”, I heard Mr. Statzer repeating what I’d said to his wife. 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I thought, he just wanted to graduate from college. ”, about a year before died... A bump, blow, jolt, or longer of his face and forehead were gone Utahans... Tbis that occur each year following a head injury include: skull fracture — a Diffuse injuries... Next wave of inevitable horror he placed heavy blankets over the speakers: Attention... Worse outcome from concussions was failing may be slower among older adults, young children and. That youngsters need to do it right now, or other head injury causes damage to the had! Different effects occurred from hitting your head at a different speed or other reasons of bleeding within the brain ’. So he knew where everything was lab now. ” sudden momentum or movement change medics been...