#ConcussionProtocols

[treatnow]

Concussion: Brain Wounding Typically Not Treated

Every person with a Concussion has a right to be told that a safe and effective treatment exist to help heal the brain wound. Hoping a Concussion Protocol will somehow allow a brain wound to heal borders on medical negligence. Concussion Protocols worldwide have a built-in bias toward an outmoded approach to brain wounds/TBI/PTSD/Concussion/BLAST. None of the protocols mention Oxygen treatment to repair the underlying brain wound/trauma caused by the concussion. They offer "resting" advice to parents of children with concussions, who often have debilitating symptoms. Concussions are a brain wound, a form of Traumatic Brain Injury (TBI) A concussion is a wound/physical tauma to the soft tissue we call the brain. A concussion begins a negative “concussion cascade” that can lead to serious and sometimes fatal consequences. This brain wounding is accompanied by symptoms of confusion or disorientation, sometimes loss of consciousness, and memory loss. It is often described as having your "bell rung." While it is true that these symptoms will diminish over time in many cases, there can be long-term physiological and other consequences when you do not treat the brain wound. What is this Concussion Cascade, and why haven’t I been told about it? It has been very difficult to “see” the wound/damage to the brain on routine X-rays, including CT scans and MRIs. Medicine diagnoses concussions by identifying the symptoms. You are assumed to be “better” when those symptoms go away. Doctors typically say that 80-90% of concussions heal on their own. What about the 20% whose symptoms remain? The Concussion Cascade can include these findings: - Inflammation - Reduced blood flow and oxygen delivery to brain cells - Reduced nutrients and enzymes necessary for wound healing/repair - Physical damage to brain matter at the microscopic level and not seen on X-rays, CT scans or MRIs - Oxygen starvation/hypoxia - Cell inactivation and death - Buildup of waste in the brain that can lead to chronic traumatic encephalopathy (CTE) in some cases And don't be shocked to learn that the same people that tell you everything will be fine in time, they are quick to warn about a second concussion. But if everthing is okay if you follow the Concussion Protocol, why worry about a second or a third? Well, maybe because there is residual damage from the brain wound that never healed. Concussions are typically a mild form of traumatic brain injury (mTBI). To understand concussions in the context of all brain wounds, it is instructive to look at just a few of the brain wounds we deal with every day. None are to be taken lightly, yet most are never treated properly: as a brain wound, not as a mental health problem that will somehow magically heal via "the tincture of time." Traumatic Brain Injury (TBI). Traumatic Brain Injury (TBI) is an injury to the brain caused by an external force, such as a blow to the head, a penetrating head injury, or a blast injury.  Major Symptoms of TBI can vary greatly in severity and may include: Physical Symptoms: Headache  Nausea and vomiting  Dizziness or loss of balance  Fatigue or drowsiness  Sensitivity to light and sound  Blurred vision  Changes in speech  Weakness, numbness, or tingling in extremities  Seizures  Cognitive Symptoms: Confusion  Difficulty thinking clearly  Memory problems  Difficulty concentrating  Slowed thinking or processing information  Problems with judgment  Behavioral or Mood Symptoms: Irritability  Agitation  Anxiety  Depression  Aggression  Changes in personality  Severity of TBI: Mild TBI (concussion):May involve a brief period of unconsciousness or disorientation.  Medicine says that symptoms typically resolve within a few weeks, but they do little to adequately treat and heal the brain wound Moderate TBI: Loss of consciousness for an extended period. Possible confusion and disorientation for hours or days.  May experience more severe cognitive and physical symptoms. Severe TBI: Extended period of unconsciousness or coma.  Significant neurological damage.  May result in long-term disabilities.  BLAST damage. Blast injuries occur when explosions create high-pressure waves that can damage sensitive organs like the ears and brain. A blast injury is caused by the intense energy released in an explosion and can lead to a wide range of injuries, depending on the type of blast. 1. Primary Blast Injury This type of injury results from the direct effects of the blast wave on the body. It primarily affects air-filled organs, such as the lungs, ears, and gastrointestinal tract. - Concussion or brain injury: Loss of consciousness Headache Dizziness Cognitive difficulties (memory loss, confusion) - Ear damage: Tympanic membrane (eardrum) rupture Hearing loss or decreased hearing Tinnitus (ringing in the ears) Ear pain or pressure Balance issues or vertigo - Pulmonary (lung) injuries: Pulmonary contusion (bruising of lung tissue) Pneumothorax (collapsed lung) Hemothorax (blood in the chest cavity) Respiratory distress or failure Hypoxia (low oxygen levels) Acute respiratory distress syndrome (ARDS) - Gastrointestinal injuries: Bowel perforation or rupture Abdominal pain or distension Nausea and vomiting Gastrointestinal bleeding General Symptoms of Blast Injury - Shock (hypovolemic or neurogenic shock) - Pain (due to tissue damage, fractures, or burns) - Confusion or altered mental status (due to brain injury or shock) - Loss of consciousness (can be temporary or prolonged) - Respiratory distress (due to lung damage or blocked airways) - Bleeding or bruising (due to internal injuries or shrapnel wounds) - Fatigue and weakness (due to trauma or blood loss) Long-Term Effects - Cognitive or psychological issues (such as memory problems, mood disorders) - Chronic hearing loss or tinnitus - Post-traumatic stress disorder (PTSD) - Chronic pain and disability due to fractures or soft tissue damage - Pulmonary problems or chronic lung disease (if lung injury was significant) Polytrauma and Operator Syndrome are more complex and additive injuries suffered along with brain wounding. What is true for mTBI/Concussion is also true for these conditions. Short of death, these are the worst war and accidents can serve up. Proper diagnosis and proper treatment are mandatory to restore near-normal function. And that includes treating and healing brain wounds. You do not have to sit idly by hoping a Concussion will heal on its own when you follow the Concussion Protocol. NOTE: Ask yourself where in the NFL Concussion Protocol, or ANY protocol in high school or college or the NHL or FIFA or your local hospital, any attention is paid to treating and healing the brain wound. Here's a taste: The NFL Concussion Protocol is a multi-step process designed to evaluate and manage players suspected of having a concussion. Here's a simplified summary:  1. On-Field Evaluation: - Spotting the injury: If a player displays concerning symptoms (e.g., dizziness, confusion, loss of balance) on the field, medical personnel are immediately alerted.  - Sideline assessment: A brief initial evaluation is conducted on the sideline to assess for any "no-go" symptoms (e.g., loss of consciousness, seizures, severe motor weakness).  2. Locker Room Evaluation: - More thorough examination: If concerns remain, the player undergoes a more comprehensive evaluation in the locker room. This includes neurological tests, cognitive assessments, and balance tests.  3. Independent Neurological Consultant (INC) Evaluation: - Independent assessment: An independent neurologist examines the player to provide an unbiased evaluation.  4. Return-to-Play Protocol: - Gradual progression: Players must pass through a series of steps before returning to play, including: Rest: Initial rest and symptom monitoring. Light aerobic exercise: Gradually increasing physical activity.  Non-contact drills: Introducing non-contact football activities.  Contact practice: Gradual reintroduction to contact drills. Full practice participation: Returning to full practice with the team. 5. Ongoing Monitoring: - Continued observation: Players are closely monitored for any recurring symptoms throughout the return-to-play process.  Key Points: - Player safety is paramount: The protocol emphasizes the importance of player safety and aims to prevent premature return to play.  - Independent evaluation: The involvement of an independent neurologist ensures unbiased assessment.  - Gradual progression: The step-wise approach allows for a safe and gradual return to play.  - Ongoing monitoring: Continuous monitoring helps identify any potential complications. Note: not a word about brain inflammation, reduced oxygen, healing the brain wound. The NFL spends more time healing ACLs, hamstrings, and broken bones than it does on brain wounds. Yet more former players succumb to suicide or CTE than to orthopedic injuries. Of course, those players are off the NFL's books by that time. Heal Brains. Stop Suicides. Restore Lives. TreatNOW ****************************** The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of Concussion, BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma from AHI and Burn Pits. www.treatnow.org Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[edswoggle]

Yo 😳 #concussion #concussionprotocol @nfl #NFL @miamidolphins #MiamiDolphins @tuaman #Tua https://www.instagram.com/p/CjRHWgIvvo0/?igshid=NGJjMDIxMWI=

[markhandlovitch]

Enjoying a little time with the kid after a quick neurology 🧠 appointment. Doc said he's normal, now we know something is wrong🤣. Now it's back to college for the kid and back to work for us. #familytime #collegelife #westpennhospital #neurology #concussion #concussionprotocol (at Strip District, Pittsburgh) https://www.instagram.com/p/B89TJ00B0mu/?igshid=1hz87m1fqudhj

[newslookout]

Should PL re-evaluate concussion protocols? | Premier League | NBC Sports

The Premier League halftime show takes a look at the David Luiz and Raúl Jiménez collision and discusses whether the league should re-evaluate their concussion protocols. #NBCSports #PremierLeague #ConcussionProtocols » Subscribe to NBC Sports: https://www.youtube.com/nbcsports?sub_confirmation=1 » Watch Live Sports on NBCSports.com: http://www.nbcsports.com/live » Get more Premier League news on NBC Sports: https://nbcsports.com/soccer/premier-league

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Should PL re-evaluate concussion protocols? | Premier League | NBC Sports https://www.youtube.com/nbcsports

The post Should PL re-evaluate concussion protocols? | Premier League | NBC Sports appeared first on News Lookout.

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[william9holla]

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A post shared by Johnathan Derseraux (@william9holla)

#ncaafootball14 #EAsports #Madden19 #concussionprotocol #tomBrady #n64 #gridiron #Madden2002 https://www.instagram.com/p/Bmrpx0PHKO5/?utm_source=ig_tumblr_share&igshid=1tzderflap0sb

[120inna55]

We heard a thud on the kitchen window, and @rush_light_ found this stunned Downy Woodpecker in the leaves. She cradled him in the her hands in the sun for a good 10 minutes before he was able to shake loose the cobwebs and fly off. #nature #birds #woodpecker #downywoodpecker #concussionprotocol #pullup #inertialdampenersareoffline #easttexas #hiltonhouse #120inna55 (at Baxter, Texas)

[michealbui]

Kelce's out! #concussionprotocol

[pbjmediaottawa]

Every member of “Rowan’s Law” receiving the Canada 150 Inspiration Award today is or has been a member of the executive or contributed to the club and promoting rugby in some cases across the globe. Rowan’s Law grew out of tragedy in our own community and family but it also sprouted out of the support and hard work of members of this club and community. It is now reality and will hopefully give the tools to keep athletes safe and our sport and club growing. So proud of so many, and yes individuals received awards today but it truly was a community and club effort. ===================== #rowanslaw #concussion #concussionprotocol #myottawa #lisamacleod #ottawa #ottawarugby #rugbyottawa #barrhavenrugby #barrhavenscottish (at Barrhaven, Ontario)

[treatnow]

BRAIN WOUND UPDATE #10: AVIV Clinic Press Release: Review of Scientific Basis of HBOT for TBI

BRINGING YOU CURRENT INFORMATION ABOUT HOW TO HELP TREAT AND HEAL BRAIN WOUNDS: CONCUSSIONS, TBI, PTSD ORLANDO, Fla., Aug. 01, 2023 (GLOBE NEWSWIRE) -- Aviv Clinics, one of the most advanced brain clinics in the world, shares the results of a new comprehensive literature review that shows hyperbaric oxygen therapy (HBOT) should be recommended as an effective therapy for patients suffering with chronic mild traumatic brain injury (TBI). Chronic mild traumatic brain injury occurs when symptoms from a mild traumatic brain injury are prolonged and last for more than six months. The literature review, The efficacy of hyperbaric oxygen therapy in traumatic brain injury patients: literature review and clinical guidelines, was conducted by the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center, Tel Aviv University and University of Pittsburgh Medical Center’s neurosurgery department, and published in the official journal of the European Society of Medicine, Medical Research Archives. The literature review evaluated articles and human clinical trials data from 1969 to April 2023 that provided detailed information on the type of HBOT treatment and clinical outcomes. The articles were categorized into acute-subacute traumatic brain injury and chronic traumatic brain injury and evaluated by HBOT experts and esteemed research leaders Dr. Shai Efrati, director of the Sagol Center and co-founder of Aviv Scientific; Dr. Amir Hadanny, chief medical officer at Aviv Scientific and chief medical research officer at the Sagol Center; and Dr. Joseph Maroon, vice chairman of the Department of Neurological Surgery at the University of Pittsburgh Medical Center. The literature review concluded that HBOT should be recommended for chronic traumatic brain injury for a selected group of patients suffering from prolonged post-concussion syndrome (PPCS) who have clear evidence of metabolic dysfunctional brain regions and who have been properly evaluated by standardized cognitive tests and functional brain imaging. Evidence involved in the review, including seven randomized controlled trials and six prospective studies, suggested significant improvement in cognitive function, symptoms and quality of life in patients with chronic mild traumatic brain injury. For acute moderate-severe TBI, the review concluded that HBOT may be recommended as a treatment but explained that further studies are needed to both evaluate outcomes and determine the optimal treatment protocols. Evidence in the review, including nine randomized controlled trials, one meta-analysis and two prospective studies evaluating the clinical effects of hyperbaric oxygen therapy in patients suffering from acute and subacute traumatic brain injuries, showed mortality was significantly reduced but mixed results for favorable functional outcomes in survivors. “This literature review scoured an immense amount of data related to HBOT as a therapy for traumatic brain injury, and the evidence that HBOT is effective against chronic traumatic brain injury is clear,” said Dr. Amir Hadanny, Chief Medical Officer at Aviv Scientific and Chief Medical Research Officer at the Sagol Center. “When looking at the comprehensive data over a larger stretch of time, we’re seeing the quality of studies have improved, and it’s exciting to see HBOT research heading further in the right direction. Many people are dealing with symptoms of chronic traumatic brain injury, and the current rehabilitation methods are limited in their efficacy. The science behind how HBOT can be effective is evident, and there is hope for those who are suffering.” HBOT is a medical treatment in which 100% oxygen is administered at an increased environmental pressure. Aviv’s unique HBOT protocol, the hyperoxic-hypoxic paradox, fluctuates oxygen levels during treatment and is being used to repair and regenerate damaged brain tissue in several types of brain injuries including traumatic brain injury, stroke, PTSD, long COVID and age-related cognitive decline among others. Previous studies from the research team at the Sagol Center for Hyperbaric Medicine and Research have demonstrated the efficacy of HBOT as a treatment for persistent post-concussion syndrome (PPCS), suggesting that HBOT improves cognitive function, behavioral function and quality of life in both adult and pediatric patients suffering from PPCS at the chronic stage, even years after their injury. Aviv Clinics offers an advanced treatment program with a multidisciplinary team of medical experts providing patients with top-line care and the opportunity to improve their quality of life. The Aviv Medical Program includes an in-depth assessment of the patient’s physical and neurological condition to assess the fit for the program. For patients that meet the criteria, the Aviv team will then prepare a comprehensive treatment schedule combining HBOT with personal cognitive training, and physical and dietary coaching, for a holistic approach to patient health. The HBOT sessions are conducted in state-of-the-art multiplace chambers that are comfortable, safe and allow for medical staff to accompany patients during the treatment. The elevated pressure in the HBOT chamber creates an optimal oxygenation condition, ultimately encouraging damaged brain and body tissues to regenerate and heal. The full study is available here. For more on Aviv Clinics, visit aviv-clinics.com Aviv Clinics is the leader in the research and treatment of age-related cognitive and functional decline and novel applications of hyperbaric oxygen therapy (HBOT) to maximize human performance. Based on an exclusive partnership with the world’s largest hyperbaric medicine and research facility, the Sagol Center at Shamir Medical Center in Israel, Aviv is introducing a global network of clinics delivering the most effective evidence-based treatment of the aging related decline – the Aviv Medical Program. The three-month regimen, designed to improve the aging-related decline in healthy adults, was developed based on over a decade of research and thousands of patients treated worldwide under the scientific leadership of Shai Efrati, M.D., chair of Aviv Scientific’s Medical Advisory Board and director of the Sagol Center. Media Contact: Ellie Holt eholt@uproarpr.com ########## The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can help heal the symptoms and effects of acute concussion/TBI/PTSD by helping heal brain wounds. Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[treatnow]

Explaining the Myths and the Myth-Makers Behind the Concussion Protocol

Bloodletting became popular in early American history; Benjamin Rush, a prominent Philadelphia physician and a signer of the Declaration of Independence fiercely advocated its use. One critic wrote: “By virtue of his social and professional prominence, his position as teacher and his facile pen, Benjamin Rush had more influence upon American medicine and was more potent in propagation and long perpetuation of medical errors than any man of his day. To him, more than any other man in America, was due the great vogue of vomits, purging, and especially of bleeding, salivation and blistering, which blackened the record of medicine and afflicted the sick almost to the time of the Civil War.” BOTTOM LINE UP FRONT: Concussion Protocols are rooted in a series of medical myths: the "best treatment" for a Concussion is recognition, rest, time, symptom reduction, second-hit avoidance, information, and certainty that most concussions heal on their own. So, just give them time. This medical negligence allows too many victims of brain wounds to slowly atrophy and die of complications attributable to untreated wounds to the brain. ************ Bloodletting, or phlebotomy, was one of those centuries long medical activities that finally surrendered to modern science. Loss of too much blood under medical supervision probably killed George Washington. Though still used in some accredited interventions, we have learned much more about disease and are aware of the grip that guessing and hoping and "truth" held over physicians. Gratefully, time has helped advance the practice of healing. But not where concussions are concerned. Myths are stories told to get people to believe. They are widely held but mostly false ideas and beliefs. Historically they are marketing devices to convince a whole class of people to believe and act in a certain way. Stories told long enough become "truth." Bear with me; this all relates to why “appropriate health care professionals” worldwide with certified Concussion expertise get it so wrong, and en masse. Memes, which circulate units of cultural information much in the same way genes pass on biological information, can become pathological when they propagate false ideas. They become like "thought viruses" that have to be fought and eradicated. Centuries of medical myths have killed. As Heston and Gosselin have put it: Putting logic ahead of the scientific method, excessively relying upon expert opinion, and an incomplete understanding of biostatistics all contribute to the etiology of a medical myth. Yuval Noah Harari in NEXUS makes a salient point: when religion and medicine together create a myth, it is liable to stick around for centuries. Witch hunting was sanctioned to root out a global satanic conspiracy that was polluting civilization. Orgies, cannibalism, child murders, satanic conspiracies and pollution of genetic purity still fuel "witch hunts" to this day. The point is that wrong ideas do not have to be true to have staying power, and to defeat facts. Wrong ideas have power to kill good ideas, good science, and evidence based medicine. The NFL has done a terrific job of embedding itself so deep into American society that it has the overtones of a religion. And the NFL's protocol has the "weight of evidence" behind it. To repeat: nothing in the NFL's Concussion Protocol, especially the Return to Participation Protocol, discusses a brain wound, or intervention with HBOT to reduce inflammation, flood the brain with oxygen, and heal the wound. It is all about symptom identification and resolution, despite accumulating evidence that delay in actual brain wound treatment can lead to lifelong degeneration. The myth continues: Keep adding to observers to ensure we don't miss the symptoms, but just wait a while for them to go away. That blue tent on the sidelines and the walk to the locker room are for privacy and diagnosis, not healing medicine. We'll keep coming back to the Myths and Myth Makers in the coming weeks. NOTE: One professional society that continues to evolve around Veterans' issues is the Court system. The first Veteran Treatment Courts (VTC) was created in Buffalo, New York in January 2008. The number of VTCs has since grown to over 600 in the United States as of 2021. VTCs know enough about Veteran trauma to know that a new/enhanced system to treat Veterans in legal peril was required. Would that the medical culture had evolved vis-a-vis TBIs; Veterans would be receiving brain wound healing that we now know is superior to life-saving compared to the standard of care in the VA. NOTE: To experience the birth of a series of concussion myths and mythmakers, view "League of Denial." NOTE: A new study out of England "suggests that repeated head injuries, such as concussions, a known risk factor for Alzheimer’s disease (AD), may reactivate a common dormant virus in the brain, increasing the risk of AD and other neurodegenerative conditions. Researchers found that even mild brain trauma can trigger this chain reaction, leading to harmful changes associated with memory loss and cognitive decline. When the brain tissues were exposed to repeated "mild blows," the previously dormant HSV-1 virus became active. This reactivation triggered inflammation, beta-amyloid plaque build-up, and the formation of harmful tau proteins, which can damage brain cells and impair memory." ****************************** The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of Concussion, BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma from AHI and Burn Pits. www.treatnow.org Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[treatnow]

What the world knows that the VA does not: Hyperbaric Oxygen Therapy is safe, effective and can restore health

Athletes are waking up to the Use of Hyperbaric Oxygen Therapy for brain wound healing, health, endurance, peak performance, and the competitive edge. Game Changer for Football Teams? A high-profile college football program began using HBOT to manage player injuries and fatigue. The therapy quickly became a key factor in their injury management and prevention strategy. The team noted shorter recovery periods after injuries, and players were able to return to play faster than before, demonstrating HBOT's efficacy in a high-contact sports environment. Numerous professional athletes use HBOT. 100 Yards of Wellness Will Offer HBOT to Clemson Athletes Nov 22, 2022 100 Yards of Wellness, Clemson’s new $4.9-million wellness space at Allen N. Reeves Football Complex that spans roughly 300 feet in length that has become a central hub of activity and major point of pride for Tiger football. The treatment and training room area includes all requisite athletic training resources, including a diagnostic office with a full digital X-ray space and diagnostic ultrasound, general medical exam room, 30 yards of turf and hydrotherapy areas, including two underwater treadmills. Among the many features of the recovery center are: • A hyperbaric chamber to create a pressurized environment for concentrated oxygen intake. • A cryotherapy chamber for muscle recovery through extreme cold temperature exposure. • A sensory deprivation float tank that houses 1,200 pounds of Epsom salt dissolved in water at skin temperature to remove athletes from light, sound and some gravitational force. • Infrared hyperthermic Cocoon pods for Far-Infrared light therapy and vibrational massage. • Photobiomodulation therapy beds that leverage multiple wavelengths of infrared light to reduce oxidative stress. • Numerous massage chairs, including both percussive massage and hydromassage options. • Percussive Hypervolt massage guns. • Dedicated tables and space for practitioner-assisted stretching, percussive massage gun therapy and Normatec compressive sleeves provided to each player prior to the season. • Functional testing equipment to obtain objective information on student-athlete muscle and joint function that can be used for injury prevention and return-to-play purposes. The Rise of Hyperbaric Oxygen Therapy in Professional Football: A Game-Changer for Recovery and Performance Sep 5, 2023 By Mudassir Sajad In the fast-paced world of professional football, where every second counts, players are constantly seeking ways to gain a competitive edge. One such method that has been gaining traction is Hyperbaric Oxygen Therapy (HBOT). This innovative treatment has been endorsed by top-tier athletes like Mo Salah, Marcus Rashford, Vinicius Junior, and Neymar, who have all been spotted on social media using hyperbaric chambers Hyperbaric Oxygen Therapy is proving to be a revolutionary treatment in the realm of professional football. Mo Salah, Marcus Rashford, Vinicius Junior, and Neymar endorsing its benefits, it's clear that HBOT is more than just a passing trend. Moreover as science continues to validate its efficacy, we can expect to see more football clubs adopting this cutting-edge technology to give their players the competitive edge they need. Dr. Joe Maroon on Hyperbaric Oxygen Dr Joe Maroon Joseph Maroon is an American neurosurgeon, author, and triathlon athlete. He is the professor and vice chairman of the Department of Neurological Surgery at the University of Pittsburgh Medical Center and is the current medical director of WWE. For over 20 years he has served as the neurosurgical consultant to professional and college athletes in football, baseball, golf, hockey and soccer and was team neurosurgeon to the Pittsburgh Steelers for over 40 years. As early as 2011, Dr Maroon and Dr Bost wrote: "Alternative nonpharmaceutical treatments appear to be gaining acceptance for the treatment of common neurodegenerative conditions, memory decline, and reduced cognitive function. Substantial animal and human research now suggests that these same natural dietary supplements, vitamins and minerals, and the use of hyperbaric oxygen may be a better first-line choice for the treatment of PCS, which has generally been underreported by both athletes and the military." Maroon and Bost, Concussion Management at the NFL, College, High School, and Youth Sports Levels. Clinical Neurosurgery. Volume 58, 2011, Chapter. 7. The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, and heal brain wounds to end the effects of BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma. www.treatnow.org Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[treatnow]

CTE Plagues Heisman Trophy Winners and Families

Three-quarters of 1,035 brains of football players -- over 700 --examined at Boston University had CTE The "taboo topic" is the centerpiece of "The Other Heisman Club" in the Washington Post, Dec 9, D1, by Kent Babb: the number of former Heisman winners with diagnosed or suspected Chronic Traumatic Encephalopathy (CTE). The degenerative brain disease is increasingly in the news for a number of reasons. Four Heisman winners have been posthumously diagnosed with the disease: Howard Cassady, Pat Sullivan, Paul Hornung and Charles White. The implication in the article is that more winners already exhibit symptoms of CTE but whose families can't "know" until after death. But the families know. Something is wrong. Sadly, silence is the preferred approach. And the unwillingness of our society to confront the obvious doesn't make it any easier. And the "whistling through the graveyard" approaches to concussions and the Concussion Protocols used worldwide don't provide much guidance about an alternative approach to Brain wounding. Facts matter: - Four percent of Heisman trophy winners died of CTE, and the list of their wounded fellow winners is growing. If you extrapolate those numbers to the 25,000 former NFL players, over 1,000 of them are probably carrying the CTE markers. - Three-quarters of 1,035 brains of football players, 0ver 700, examined at Boston University had CTE. - Researchers at Boston University found CTE in 92 percent of former NFL players who were analyzed: they analyzed the brains of 376 deceased former NFL players and diagnosed 345 of them with chronic traumatic encephalopathy. - More than half of the homeless have experienced traumatic brain injury and 1 in 4 have had moderate to severe brain injuries. - Approximately 876,450 post-9/11 veterans suffer from untreated brain wounds. - Researchers estimate that as many as 60% of incarcerated individuals are living with TBI, significantly higher than the 8.5% reported in the general population. - Studies on prison and jail populations have reported a range of 25-87% of inmates reporting head injuries or TBI. Of course, it is traditional to attack these numbers. Nay-sayers will demand more research. Hand-wringing by stake-holders on both sides will, like protests after mass-shootings, last a while and then subside. If anything, more dollars will go into researching how to make contact sports more safe. And treatments that are non-pharmaceutical will be ignored. Since "everyone knows there's no treatment for brain injuries," the best we can hope for from the medical profession is contained in the latest proceedings out of Boston. The Robert C. Cantu Concussion Summit was held on December 8, 2023, at the Cantu Concussion Center at Emerson Hospital in Concord, MA. The theme of the conference was "Prevention of Concussion and Long-Term Effects of Repetitive Traumatic Brain Injury (RTBI)." In what is becoming a repetitive list of findings, the conference summarized: - Eliminate intentional or avoidable head impact in contact and collision sports in both practices and games. - Encourage policies and rules that limit the number, duration, and intensity of contact sport practices. - Reinforce proper and safer techniques that avoid head contact at all levels of play. - Implement rules of play that reduce and penalize intentional or avoidable contact to the head and neck. - Correlating specific clinical symptoms with CTE neuropathology remains an important area for further investigation. - Improve the criteria for Traumatic Encephalopathy Syndrome (TES) through further research. Feel better? More importantly, if you are the parent of someone with a brain wound, what actionable intelligence can you take from that list? How will that list help you and yours deal with the here-and-now of a TBI/Concussion-suffering loved-one? If you'd like to learn more about what is happening, and what you can do, view this earlier Blog. Additional information is here. Below is an  insightful film about brain wounds  https://youtu.be/Zzbxrnm7jXc?si=IPKC5InadR0Eho52 https://treatnow.org/brain-wound-update-5-concussion-blast-tbi-cte/ The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help heal the effects of BLAST injury, TBI/PTSD, and acute concussion. Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

[treatnow]

NYT: Friendly Fire Leads to Brain wounding

Pentagon researchers say weapons like shoulder-fired rockets expose troops who fire them to blast waves far above safety limits, but they remain in wide use. As we have reported for years, BLAST injury does not respect your nationality, gender, origin of the weapon, or your intention. As Dave Philipps of the New York Times reports, U.S. Troops are still training on weapons with known risks of delivering brain wounds. As Phillips reports, studies by the Navy, the Center for New American Security, the Swedish military, DoD, SEALs, DARPA, Johns Hopkins, and UHUHS all warn of real damage inflicted by "friendly fire". The search, research, measurements, data bases, added budgets, and periodic expressions of concern from DoD leadership can be viewed in one of two lights: they know and they don't care; or, they know and they dont' know what to do in the interim. Modern warfare, as Ukraine proves daily, requires more and more destructive firepower just to defend territory, let alone regain strategic and tactical advantage. So, what can done in the interim? "For generations, the military assumed that this kind of blast exposure was safe, even as evidence mounted that repetitive blasts may do serious and lasting harm. . . . Top leaders talk of the importance of protecting troops’ brains, but the military fails to take practical steps to ensure safety." Literature on BLAST injuries over the past decade overwhelmingly tends in the direction of Recommendations to find ways to protect soldiers with new and improved helmets, reduced weapon firings, education, more research, more funding, and, over time, resort to robots to do the heavy firing. Sadly for the soldier, for 100 years we've known that BLAST causes brain wounds. Even though a century of research has not definitively "proved" the Mechanisms of Action involved in causing physical, mental, behavioral, cognitive, and moral damage, we do know that the net effects of only palliating symptoms won't lead back to a normal, healthy brain. So here's a list of helpful suggestions to DoD/VA to help Warriors, Veterans, indeed anyone exposed to BLAST injury or brain wounding. Let all the research continue on mitigating the potential and actual damage caused by exposure to BLAST. Add more drugs and hallucinogenics and psychotropics to the list of possible "solutions." But let's focus some of our work on healing the wounds to the brain and body caused by BLAST exposure. An estimated 877,000 Veterans and active duty service members -- probably many more as we learn about the pervasiveness of self-inflicted BLAST injury -- are already suffering with some degree of brain wounding. Let's focus on HEALING THEIR BRAIN WOUNDS as we work the prevention side of the equation. Here's a modest proposal: Daily suicide rates, accumulating suffering, and impacts on families demand that we deal with brain wounds. We cannot continue to ignore treatments that work are safe, scientifically validated, and readily available. We cannot hide this information from the wounded. Informed consent and medical ethics demand that DOD/VA tell the wounded what is available, even though it is "off-label." Every treatment, drug, process, procedure, device and protocol currently used by DoD/VA is off-label and not approved by the FDA for treating TBI/PTSD. Keep doing what you're doing. But hold open the possibility that alternative therapies exist that are scientifically valid, clinically proven, widely available, cost effective and demonstrated safe and effective. Fund them. Rethink a Suicide Prevention Strategy that is void of any options to treat brain wounds. Too may Veterans commit suicide -- over 109,000 -- perhaps falling into depression from undiagnosed and untreated brain wounds. Hyperbaric Oxygen Therapy (HBOT) is one such therapy, backed by decades of research, acceptance by the FDA for wound healing, and proven in multiple scientific studies to reduce or eliminate symptoms caused by TBI/PTSD/Concussion/BLAST. HBOT is proven to reduce and/or eliminate suicidal ideation in tens of thousands of uses . Read, really read, the current scientific literature on the validity of objective research conducted over the past fifteen years. Notice that the UHMS and the overwhelming number of real HBOT researchers know that HBOT works to help heal TBI/PTSD. Even government researchers, a few of whom still cling to the canard that "HBOT does not work," accept that patients in their studies got better . If necessary, take 10% of the VA drug budget and use it to fund HBOT treatments in private clinics where the cost is miniscule compared to current standards of care. It is a well-known fact that fully treated HBOT patients get off almost all their drugs, many of which warn of "ideation of suicide." There will be a net return of billions of dollars to the VA bottomline due to reduced need for prescriptions. Redo your cost analyses when considering where to spend dollars on rehabilitation of brain wounded combat Veterans. It has been calculated that the cost of NOT treating brain wounded Veterans will exceed $4Trillion over their 40-year lifespan. That's a degraded life, for the Veteran and the family, living with symptoms that plague far too many Veterans. For less than 1/2 of 1% of that cost, all 877,450 brain-wounded Veterans can be fully treated with HBOT. DoD and the VA should insure and reimburse HBOT-for-TBI treatments. Start with Informed Consent: let every Veterans know that HBOT can help heal their brain wound. And consider the following: service members returning from combat suffer from polytrauma unlike ever before. Knowing what we know now about the prevalence of BLAST injury, Burn Pit toxins, unreported brain trauma, the sustained pace of combat for Special Operations warriors, we need to provide functional medicine approaches to whole body wellness, starting with but not limited to brain wounds. All body systems are negatively affected by BLAST. HBOT works to relieve pain, reduce inflammation, speed healing, restore function, promote the growth of new stem cells, and allow battle-weary warriors to return to peak performance more quickly. Part of the history of HBOT is that the history of HBOT safety and efficacy is ignored or forgotten. This is a page out of the Textbook of Military Medicine, updated in 2006. This same algorithm is in the textbook in the 1980s. The “definitive therapy” then and is HBOT treatment for TBI resulting from BLAST Exposure.

The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help heal the effects of BLAST injury, TBI/PTSD, and acute concussion. Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

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BRAIN WOUND UPDATE #13: Holistic Total Force Fitness to Maximize Performance

BRINGING YOU CURRENT INFORMATION ABOUT HOW TO HELP TREAT AND HEAL BRAIN WOUNDS: CONCUSSIONS, TBI, PTSD A senior retired US Navy SEAL officer has weighed in with a six part justification for ACTION to fight suicide. His remarks relate to short- and long-term needs for dealing with force readiness amidst known challenges in the SpecOps community. His remarks are in concert with the Interview with the Senior Enlisted Advisor to the Chairman of the Joint Chiefs of Staff (SEAC), Ramón Colón-López that follows his remarks. ************** Holistic Total Force Fitness to Maximize Performance 1. The M16A2 was discarded in SOF beginning in 1992 with the introduction of the CAR-15 and M-4 in the early 90’s.  I was witness to that. The shortened barrels were, to say the least, "most noticeable", and in live fire drills, the concussive forces were enhanced around operators. Conventional forces did not receive these shortened rifles until circa 2010 in response to the need for shortened barrels in urban combat, which then also exacerbated the concussive forces during CQB operations in rooms. Constant exposure to shoulder-fired rockets, mortar, and artillery fire added to the cumulative effects. This is to say nothing about the constant exposure to IED blast waves, which, were the most injurious, and close-air support blast waves. All those constantly exposed to these concussive forces over multiple deployments will have physiological effects, lending to the neurological. 2. TBI, given the above, is akin to Decompression Sickness, physiologically, again lending to the neurological issues. Research has documented the evidence. The Textbook of Military Medicine, the volume entitled Ballistics, Blasts and Burn Injuries, has an algorithm on page 313. It is entitled Neurological Abnormalities in the Blast Casualty. HBOT is identified as definitive as treatment option. 3. This is not to discount the need for counseling; however, as I discussed with seniors, any operator, SOF or otherwise, who seeks help for TBI and suicidal ideation, is often stigmatized. It is akin to one seeking help for a perceived alcohol problem. We have witnessed those men and women immediately being separated from their comrades, which is in itself harmful, and the same appears to be the case for this issue. Rather, the solution should be immediate treatment with HBOT while still “on-the-line”, or, taken “off-line” as one would be for any illness while still retaining group and billet status.  For any SOF operator, especially, referring to this in that light also de-stigmatizes the problem.  4. HBOT should be a health maintenance issue to deal with the prevalent and cumulative concussive forces from live fire in all forms.  As an aside, HBOT would also assist in treatment according to the recently passed “burn pit” legislation. All warfighters are also subjected to the noxious gasses from carbines, rockets, artillery, along with the very nasty particulate matter encountered in AFG and Iraq. This is a readiness issue. 5. HBOT should be proffered by our health professionals as a performance enhancement issue. Olympic and professional athletes utilize HBOT for this reason. SOF operators, especially, will be lining up to enhance their performance. TBI and/or residual effects could then heretofor be corrected in a positive light. Overall, though, this is a combat enhancement and effectiveness issue. 6. One must ask why hyperbaric environments are questioned for TBI when it is considered medical protocol when dealing with Decompression Sickness (DCS) and Arterial Gas Embolism (AGE), wound ostomy, diabetic neuropathy, hearing and vision loss, radiation injuries, CO and airborne particulate poisoning, severe bone and skin infections,  trauma from force or pressure on a body part.     Lastly, the constant exposure and cumulative effects to these blast waves, and the more acute exposure to the higher pressure waves in IEDs, etc, have the same effects as head trauma/ concussions in sports.  Football legend Joe Namath has had his concussion injuries healed by 120 treatments of HBOT. His testimony is available on YouTube, and, he is the proponent for chambers being emplaced in stadiums for immediate treatment in concussion protocol.  **************** Interview with Senior Enlisted Advisor to the Chairman of the Joint Chiefs of Staff (SEAC), Ramón Colón-López. The Military Heath System, together with DoD's Traumatic Brain Injury Center of Excellence, interviewed SEAC. Highlights are consistent with remarks above. The Warfighter Brain Health (WBH) Initiative is a joint effort between operational and medical communities with the focus to optimize warfighter brain health, immediately detect brain injury when it occurs and combat its effects on warfighters, their families, line leaders/commanders, and their communities at large. WBH is defined as the physical, psychological, and cognitive status that affect a warfighter's capacity to function adaptively in any environment, and impacts readiness, operational capability, mission effectiveness, and the goal to achieve overmatch or superior lethality MISSION: Act rapidly to provide products, practices, and policies to directly impact warfighter brain health and performance. Due to experience and realities across the community, a major emphasis is to understand the implications of blast overpressure (include underwater and subterranean exposures); blunt force trauma; high G acceleration/ vibration/ recoil; incoming/ near missed impact (e.g. ballistic missiles); ballistic projectiles; directed energy (e.g., electromagnetic fields (EMF) and UV radiation); chemical-biological-gas toxins; and other environmental hazards. SEAC defined "resiliency" as the threshhold for misery. No matter how resilient a warrior, symptoms keep coming. Slowed thinking, reactions, memory lapses, pain, reduced energy degrade readiness and ability to perform at peak levels. The Comprehensive Strategy for Warfighter Brain Health Initiative 2018 study on the effects of low level blasts, section 734, calls for more efforts to confront effects of Blast. SEAC referred to "the 3 greys": - grey area of new operational environment: conventional peer-to-peer has given way to unconventional warfare - grey area of grey steel deterrence: ships, missiles, aircraft are evolving to leverage the revolution in military and technical breakthroughs. - grey matter: human performance, intellect, speed of response, judgement. In this last insight, SEAC calls on the Services to pay as much attention to restoration of the human as to the weapons and the doctrine. Degraded Warriors imperil our ability to prevail. NOTE: Hyperbaric Oxygen Therapy (HBOT) meets and exeeds the challenge implicit in SEAC's challenge: Identify evidence-based cognitive and physical performance restoration treatments. **************** Worth Reading ** In the largest study of neurodegenerative disease from Boston University’s CTE Center, sixty-three out of the 152 donated brains (41%) had autopsy-confirmed CTE. All cases were athletes under the age of 30 at the time of their death. The majority were amateur athletes (71.4%). The report, published in JAMA Neurology on 28 AUG 2023 describes the features of 152 brains donated between February 1, 2008, and September 31, 2022, to the UNITE brain bank — the largest tissue repository in the world focused on traumatic brain injury and CTE. Most of the donors analyzed played football (60%), followed by soccer (15%) and ice hockey (10%). Other sports implicated were amateur wrestling, rugby and professional wrestling. The study shows that 87 of the 152 donors died by suicide, including 33 donors who also had CTE. Dr McKee noted: “The most common cause of death across the board, whether they had CTE or not, was suicide, followed by accidental overdose.” McKee adds that the longer someone plays football, in particular, their risk of developing CTE doubles every 2.6 years. ALSO OF NOTE: The healthcare costs of TBI, driven by cost prices and the healthcare consumption of patients, will cause major economic and societal challenges, as estimates indicate the worldwide annual economic burden of TBI to be US $400 billion dollars, which is 0.5% of the gross world product. ########## The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can help heal the symptoms and effects of acute concussion/TBI/PTSD by helping heal brain wounds. Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article

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Neuropathologic and Clinical Findings in Young Contact Sport Athletes Exposed to Repetitive Head Impacts

August 28, 2023 Ann C. McKee, MD1,2,3,4,5,6,7; Jesse Mez, MD, MS2,3; Bobak Abdolmohammadi, BA2; et alMorgane Butler, BSc2,8; Bertrand Russell Huber, MD, PhD1,2,3,5,6; Madeline Uretsky, MS2; Katharine Babcock, PhD2,8; Jonathan D. Cherry, PhD1,2,4; Victor E. Alvarez, MD1,2,3,5; Brett Martin, MS2,9; Yorghos Tripodis, PhD2,7,9; Joseph N. Palmisano, MS2,9; Kerry A. Cormier, BA1,2,5; Caroline A. Kubilus, BA2,5; Raymond Nicks, MS1,2,3,5; Daniel Kirsch, BA2,4; Ian Mahar, PhD2; Lisa McHale, EdS2,10; Christopher Nowinski, PhD2,10; Robert C. Cantu, MD2,10,11,12; Robert A. Stern, PhD2,3,12; Daniel Daneshvar, MD, PhD2,13; Lee E. Goldstein, MD, PhD2,14,15; Douglas I. Katz, MD3,16; Neil W. Kowall, MD2,3; Brigid Dwyer, MD3,16; Thor D. Stein, MD, PhD1,2,4,5; Michael L. Alosco, PhD2,3 Author Affiliations Article Information JAMA Neurol. Published online August 28, 2023. doi:10.1001/jamaneurol.2023.2907   Audio (16:39) Neuropathologic and Clinical Findings in Athletes With Repetitive Head Impacts  

Key Points

Question  What are the neuropathologic and clinical findings in a convenience sample of young, deceased, symptomatic contact sport athletes? Findings  In this case series of 152 contact sport athletes younger than 30 years at the time of death, chronic traumatic encephalopathy (CTE) was found in 63 (41.4%), with nearly all having mild CTE (stages I and II). Neuropathologic abnormalities associated with CTE included ventricular enlargement, cavum septum pellucidum, thalamic notching, and perivascular pigment–laden macrophage deposition in the frontal white matter. Meaning  These findings confirm that CTE and other brain pathologies can be found in young, symptomatic contact sport athletes, but the clinical correlates of these pathologic conditions are uncertain.

Abstract

Importance  Young contact sport athletes may be at risk for long-term neuropathologic disorders, including chronic traumatic encephalopathy (CTE). Objective  To characterize the neuropathologic and clinical symptoms of young brain donors who were contact sport athletes. Design, Setting, and Participants  This case series analyzes findings from 152 of 156 brain donors younger than 30 years identified through the Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) Brain Bank who donated their brains from February 1, 2008, to September 31, 2022. Neuropathologic evaluations, retrospective telephone clinical assessments, and online questionnaires with informants were performed blinded. Data analysis was conducted between August 2021 and June 2023. Exposures  Repetitive head impacts from contact sports. Main Outcomes and Measures  Gross and microscopic neuropathologic assessment, including diagnosis of CTE, based on defined diagnostic criteria; and informant-reported athletic history and informant-completed scales that assess cognitive symptoms, mood disturbances, and neurobehavioral dysregulation. Results  Among the 152 deceased contact sports participants (mean age, 22.97 years; 141 male) included in the study, CTE was diagnosed in 63 (41.4%; median age, 26 years). Of the 63 brain donors diagnosed with CTE, 60 (95.2%) were diagnosed with mild CTE (stages I or II). Brain donors who had CTE were more likely to be older (mean difference, 3.92 years; 95% CI, 2.74-5.10 years) Of the 63 athletes with CTE, 45 (71.4%) were men who played amateur sports, including American football, ice hockey, soccer, rugby, and wrestling; 1 woman with CTE played collegiate soccer. For those who played football, duration of playing career was significantly longer in those with vs without CTE (mean difference, 2.81 years; 95% CI, 1.15-4.48 years). Athletes with CTE had more ventricular dilatation, cavum septum pellucidum, thalamic notching, and perivascular pigment-laden macrophages in the frontal white matter than those without CTE. Cognitive and neurobehavioral symptoms were frequent among all brain donors. Suicide was the most common cause of death, followed by unintentional overdose; there were no differences in cause of death or clinical symptoms based on CTE status. Conclusions and Relevance  This case series found that young brain donors exposed to repetitive head impacts were highly symptomatic regardless of CTE status, and the causes of symptoms in this sample are likely multifactorial. Future studies that include young brain donors unexposed to repetitive head impacts are needed to clarify the association among exposure, white matter and microvascular pathologic findings, CTE, and clinical symptoms.

Introduction

Across the world, millions of people are exposed to repetitive head impacts (RHIs) through participation in contact and collision sports, military service, physical violence, and many other activities.1-6 Repetitive head impacts can result in symptomatic concussions and the much more frequent, nonconcussive injuries that are asymptomatic.7 Sustained exposure to RHIs can produce persistent cognitive and neuropsychiatric symptoms8-11 and a progressive, tau-based neurodegenerative disease, chronic traumatic encephalopathy (CTE).12-21 Multiple studies13,15,22 link a longer duration of RHI exposure in US football players with increased odds for the presence of CTE and increased severity of CTE. In older American football players with pathologically diagnosed CTE, RHI exposure is also associated with white matter rarefaction,23-25 loss of myelin associated proteins,26 and oligodendrocyte loss.27 Emerging data show structural white matter alterations on magnetic resonance imaging (MRI) in young, active, and recently retired contact sport players exposed to RHI,1,2,28-30 although the pathologic condition underlying these changes is unclear. A definitive diagnosis of CTE requires neuropathologic evidence of perivascular hyperphosphorylated tau (p-tau) aggregates in neurons, with or without astrocytes, typically at the depths of the sulci in the cerebral cortex.31,32 The clinical syndrome associated with CTE is known as traumatic encephalopathy syndrome (TES).8,33 On the basis of the National Institute of Neurological Disorders and Stroke (NINDS) consensus diagnostic criteria for TES,8 the core clinical features of TES include cognitive impairment, especially episodic memory and executive dysfunction, and neurobehavioral dysregulation, such as impulsivity, explosivity, and emotional dysregulation.8 Supportive features include delayed onset (ie, core clinical features starting years after RHI exposure ends), parkinsonism, other motor signs (including amyotrophic lateral sclerosis), depression, anxiety, apathy, and paranoia. The Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) Brain Bank1 has harvested brains from more than 1350 donors exposed to RHIs who are considered at risk for CTE. Brain donors in the UNITE bank vary widely in age at death and include teenagers and young adults. Chronic traumatic encephalopathy has been reported in individuals as young as 17 years,13 yet, to date, there have been no large-scale neuropathologic and clinical studies of young individuals exposed to RHIs. Attention to this age group has several important implications. The study of young athletes allows insight into the earliest features of RHI-induced neuropathologic injury and CTE. Furthermore, it allows analysis in the absence of common age-associated comorbidities. Moreover, most of these young contact sport athletes played only at amateur levels, as part of teams affiliated with educational institutions; consequently, the study of young athletes adds to our understanding of the long-term consequences of amateur contact sports participation. In this report, we describe the neuropathologic and clinical features of 152 brain donors from the UNITE brain bank who were younger than 30 years at the time of death.

Methods

Brain Donors and Study Design The initial sample for this case series included 156 deceased individuals with a history of exposure to RHIs from contact sports participation who donated their brain to the UNITE Brain Bank from February 1, 2008, to September 31, 2022, and were younger than 30 years at the time of death. Race was determined by next-of-kin report and was included to understand the representativeness of the sample and the associated generalizability of the results. Procedures of brain donation have been previously described.14,34 The inclusion criterion was based on the presence of a history of exposure to RHIs without regard to symptom status. The restriction to brain donors younger than 30 years was selected to minimize any contribution from age-related conditions. Donors were excluded for poor tissue quality. Four donors were excluded because of incomplete brain fragments or prolonged premortem hypoxia, resulting in a final sample size of 152. Institutional review board approval for brain donation, postmortem clinical record review, interviews with informants, and neuropathologic evaluation was obtained through the Boston University Medical Campus and the Veterans Affairs Bedford Institutional Review Board. The next of kin or legally authorized representative of each brain donor provided written informed consent. The methods for this report followed the appropriate use and reporting of uncontrolled case series in the medical literature reporting guidelines.35

Neuropathologic Evaluation

Neuropathologic evaluation occurred blinded to the clinical evaluation by neuropathologists (A.C.M., B.R.H., V.E.A., and T.D.S.). Pathologic processing and evaluation were conducted using previously published methods and as described in the eAppendix in Supplement 1.12-14,34,36 Neuropathologic diagnoses were made using NINDS National Institute of Biomedical Imaging and Bioengineering criteria for CTE31,32 and well-established criteria for other neurodegenerative diseases.37-40 The CTE p-tau pathologic findings were classified into 4 stages using the McKee staging scheme for CTE. Read the full article

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BRAIN WOUND UPDATE #11: Suicide Risk, Mental Health and Military TBIs

BRINGING YOU CURRENT INFORMATION ABOUT HOW TO HELP TREAT AND HEAL BRAIN WOUNDS: CONCUSSIONS, TBI, PTSD

Associating Military-Related Traumatic Brain Injury (TBI) With New-Onset Mental Health Conditions and Suicide Risk

A new JAMA study sought an answer to this Question: Is military-related traumatic brain injury (TBI) associated with increased incidence of new-onset mental health conditions and suicide risk? Findings.  In this cohort study, individuals with a history of military-identified TBI had significantly higher rates of new-onset mental health conditions than those without TBI. Increased risk for suicide was associated indirectly (through new-onset mental health diagnoses) and directly with history of TBI. Meaning. These findings suggest that conceptualizing exposures (physical, psychological) as events that accumulate over an individual’s lifetime and increase risk for negative outcomes (eg, suicide) may assist in identifying mechanisms underlying frequently co-occurring conditions, as well as evidence-based interventions. Importance.  Research to identify the direct and indirect associations of military-related traumatic brain injury (TBI) with suicide has been complicated by a range of data-related challenges.The major objective was to identify differences in rates of new-onset mental health conditions (ie, anxiety, mood, posttraumatic stress, adjustment, alcohol use, and substance use disorders) among soldiers with and without a history of military-related TBI and to explore the direct and indirect (through new-onset mental health disorders) associations of TBI with suicide. In this longitudinal cohort study of 860,892 soldiers, rates of new-onset mental health conditions were higher among individuals with a history of TBI compared with those without. Moreover, risk for suicide was both directly and indirectly associated with history of TBI. These findings suggest that increased efforts are needed to conceptualize the accumulation of risk associated with multiple military-related exposures and identify evidence-based interventions that address mechanisms associated with frequently co-occurring conditions. ******************* In another story, researchers have gained new insight on how the brain can repair itself post-stroke. Functional decline after an ischaemic stroke is a common experience for patients, especially due to the brain’s resistance to regenerate after damage. However, there is still potential for recovery as surviving neurons can activate repair mechanisms to limit and even reverse the damage caused by the stroke. The question this study looked to answer is how is it triggered? Researchers from Tokyo Medical and Dental University (TMDU) provided new insight to this question by identifying a new mechanism. They discovered that neurons surrounding the area of cell death secrete lipids that can trigger brain-autonomous neural repair after ischaemic brain injury. An ischaemic stroke occurs when the blood supply to the brain is blocked and results in the death of brain cells. This condition is life-threatening, and patients will likely develop functional disabilities. Although the adult brain can self-repair, the underlying mechanisms need further clarification. Inflammation of the brain contributes to the effects of ischaemic stroke. Senior author, Takashi Shichita, says: “There is evidence that more lipids are produced after tissue injuries and contribute to regulating inflammation. “We investigated the changes in lipid metabolite production in mice after ischaemic stroke. Interestingly, the levels of a specific fatty acid called dihomo-γ-linolenic acid (DGLA) and its derivatives increased after the stroke.” ******************* Lastly, Jeremy Renner, he of HURT LOCKER and AVENGER fame, and other roles, is taking HBOT treatments twice a day following his hellacious crushing on Jan 1 by his own snowplow. “Hyperbaric chamber, 2 atmosphere pressure, high oxygen, 2x daily,” the Hawkeye star wrote....... According to the article: "In addition to injuries, hyperbaric oxygen therapy can be used to treat other medical conditions like burns, severe anemia, carbon monoxide poisoning, radiation injuries, traumatic brain injuries, and more. It is also commonly used for treating scuba and deep-sea divers affected by the rapid pressure change." ########## The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can help heal the symptoms and effects of acute concussion/TBI/PTSD by helping heal brain wounds. Heal Brains. Stop Suicides. Restore Lives. TreatNOW Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made. Read the full article