Category: Brain Injury

Queen Liliuokalani Building, Hawai‘i Department of Education headquarters in Honolulu

All fifty states currently have some form of concussion management policy instituted to protect athletes 18 and below. Hawai‘i law (HB 2273/SD1 Act 197 of 2012) requires the Hawai‘i Department of Education and the Hawai‘i High School Athletic Association (“HHSAA”) to develop a concussion educational program.

The law ensures that there is education for students, parents, officials, faculty, coaches, and administrators about the signs and symptoms of a concussion, annual programs for coaches about the warning signs, education on the need for mandatory removal of students from activities if demonstrating the signs, education on the need for a licensed health care professional to evaluate the student and the monitoring of the student.

Every public and private school that is a member of the HHSAA must develop the school’s concussion awareness program, and every program must require:

Hawai’i is committed to athlete safety, and so is Galiher DeRobertis & Waxman. The State of Hawai’i passed legislation passed to ensure concussion awareness and management for our athletes, coaches, parents, teachers and administrators. Still, there are inherent risks to playing sports, especially football. Brain injury in football is not incidental—it is built in to the game—and many other sports have a significant risk of brain injury. Today, our youth athletes are in danger of severe and frequent blows to the head that could produce lifelong changes in mental processes.

Galiher DeRobertis & Waxman is part of a legal strategy to ensure safety for our athletes. Following the class action lawsuit against the National Football League (NFL), Galiher DeRobertis & Waxman filed a lawsuit against the NFL alleging they knew the damaging affects of repetitive brain injuries but hid this fact from players, instead encouraging them back onto the field. Wrongful death suits against the National Collegiate Athletics Association (NCAA) have also spurred action toward managing and monitoring concussions at the college level. Litigation is helping NCAA’s live up to their mission to “protect young people from dangerous and exploitative athletic practices.”

If you or someone you know has had sports-related concussions at the high-school or college level, there may be legal grounds for a lawsuit. Long-term effects of repeated mTBI include ALS, dementia and other costly disease.

Galiher DeRobertis & Waxman is dedicated to protecting the brains of our young athletes so that children can participate in sports without risking serious injury. Supporting concussion awareness is key, but so is maintaining accountability and justice.

Act Without Delay

Prompt action is required. The laws vary from state to state, but the statute of limitations in every state requires that lawsuits be filed within certain time periods. In Hawai’i, an injury lawsuit must be brought within two years of the incident. To successfully bring a lawsuit against those who were responsible, it is important to act quickly so that none of your legal rights are lost.

Signing a retainer with Galiher DeRobertis & Waxman costs nothing upfront, and ensures that you and your family are protected in the future.

It takes an integrated team to heal a brain. Everybody on your team should understand the game plan for recovery.

Explain the Injury

To Family:

Sleep hygiene means maintaining a regular wake and sleep pattern. You might need help to stay on a normal sleep schedule, especially in the beginning.

To Friends:

Mood changes are normal during recovery. Don’t be embarrassed to ask for support—or to explain you need alone time.

To Teachers:

A student athlete who has suffered a concussion may need school adjustments for a short period, usually for a couple weeks (but possibly even for months). Such adjustments include breaks as needed in a quiet place; pre-printed class notes; additional help, tutoring and time for assignments; and untimed or no testing until tolerating a full day of schooling.

To Coaches:

Talk to your coach about how to maintain a connection with your sports team during the time of recovery, even if you can’t physically play.

Behind The Symptoms

1) Trauma damages and stretches neurons, and also results in chemical changes.

2) The sudden movement cause the brain to bounce around or twist inside the skull.

3) The damage leads to breaks in the blood-brain barrier, causing inflammation.

4) Chronic inflammation may be linked to longer-term damage, perhaps even chronic traumatic encephalopathy.

Plays to Counter Your Symptoms

 

It is important to be on the lookout for signs and symptoms of mTBI. If you recognize such an injury to yourself or to anyone you care about, speak up.

 
Pain & Physical Sensation

• Headache or “pressure” in head
• Loses consciousness (even briefly)
• Balance problems or dizziness
• Nausea or vomiting
• Numbness or tingling

 

Problems With Memory & Cognition

• Appears dazed or stunned; answers questions slowly
• Can’t recall events after hit, bump, or fall
• Confusion about what has happened
• Difficulty thinking clearly, concentrating, or remembering

 
 

Vision & Sleep Disturbances

• Blurry or double vision
• Sensitivity to light and/or noise
• Drowsiness or fatigue
• Difficulty falling asleep
• Sleeping more or less than usual

 

Changes In Personality

• Behavior or personality changes
• Does not “feel right”
• Feeling slowed down, sluggish, hazy, groggy, or foggy
• More irritable, sad, nervous, or emotional than usual

 
 

The Myth

Headgear protects the brain from concussions. (It doesn’t.)

The Truth

The real damage is dealt through rotational forces that cause the brain to shear. Brain shearing is stretching what shouldn’t be stretched: brain tissue slides against brain tissue—pulling the axons particularly where white and grey matter meet.

Often brushed off as “seeing stars,” mild traumatic brain injury (also called a concussion) is a subset of traumatic brain injury that occurs when an external force alters brain function. The brain, suspended in cerebrospinal fluid, reacts to the sudden motion of the trauma. Despite the inherent resiliency in the human brain, the differential movement of brain matter causes it to bounce, twist and hit the inside of the skull.

A mild traumatic brain injury, also called a concussion, occurs when an external force alters brain function.

This leaves contusions (bruises) on the brain that produce immediate physical, cognitive and emotional symptoms such as headache, nausea, balance problems, emotional imbalance, short-term memory loss, sleep disturbances and irritability. The current understanding of mTBI involves a shift in focus from anatomical damage to a more complex neuronal dysfunction involving a cascade of ionic, metabolic and physiologic events. Brain injuries not only produce a structural change but also a chemical one, fundamentally altering our very perception of the world.

Every Concussion Is Different

Every concussion is different depending on the individual brain, the environment, the genetics, and a host of variables including where in the brain the injury occurred. The pattern of injury within the brain is significantly different depending on how the injuring force was applied to the brain. It frequently takes 2-3 weeks to recover from a concussion, although it varies from person to person. It wouldn’t be abnormal for someone to take a month or longer to recover. The most important symptoms to be aware of are behavioral: personality changes due to brain injury are the most traumatic and disruptive.

Concussions or mTBI happen most frequently during sports and recreation, motor vehicle and bicycle accents, assaults, and falls. Whether on the sports field or at home, traumatic brain injuries happen often, unexpectedly and pose risks underestimated by the general population. The injury leads to permanent or temporary impairment of cognitive, physical and psychosocial functions with an associated diminished state of consciousness. The injury is one of the leading causes of death and disability in the United States.

An Issue Nearing Epidemic Proportions

Mild traumatic brain injury is attracting greater awareness due to a national concussion crisis and the shocking dearth of knowledge regarding concussion management (particularly in schools). Speaking at the White House Concussion Summit, President Obama emphasized, “The awareness is improved today, but not by much. So the total number of young people who are impacted by this early on is probably bigger than we know.”

Congress, the White House and the CDC all agree mild traumatic brain injury is an issue nearing “epidemic” proportions. The indirect and direct cost of mTBI is estimated by the National Conference of State Legislatures to be $70 billion dollars, in addition to the emotional toll on family and friends.

Although CT scans, MRIs and PET scans can image structural abnormalities from brain injury or skull fractures, problems from concussions are based in neurometabolic damages. Scientists are researching objective diagnostic markers that could be used to diagnose concussions. Currently, the symptoms generally must be self diagnosed—the responsibility frequently falls on the individual to report symptoms rather than determined through objective diagnostic markers. When concussions occur during a sporting event, physical trainers and coaches must make high-risk judgments about whether or not to send players back into the game. As more information about the hazards emerges, it becomes clear that it is better to err on the side of caution.