Archive for category education

[WEB SITE] Spasticity – Stroke.org

Spasticity

Spasticity Awareness Week is April 17 – 21, 2017. Please join us in raising awareness about this condition that affects over 12 million people worldwide.

The National Stroke Association has partnered with a growing number of leading organizations to form the Spasticity Alliance. To commemorate Spasticity Awareness Week in 2017, the Spasticity Alliance has launched a Spanish version of its website. Both English and Spanish websites contain resources for individuals living with spasticity, family members, and caregivers who want to learn more about spasticity. The English website can be found at spasticityalliance.org; the Spanish website can be found at spanish.spasticityalliance.org.

The resources below contain information about the symptoms of spasticity, management techniques and treatments that help to ease the symptoms of spasticity. While there is no cure for this condition, there are many tactics that can help individuals living with spasticity resume their normal daily activities.

WHAT IS SPASTICITY?

After a stroke, damage to the brain can block messages between muscles and the brain causing arm and leg muscles to cramp or spasm (spasticity), kind of like a bad charley horse. This will limit your coordination and muscle movement. This post-stroke condition makes daily activities such as bathing, eating and dressing more difficult.

Spasticity can cause long periods of strong contractions in major muscle groups, causing painful muscle spasms. These spasms can produce:

  • A tight fist
  • Bent elbow
  • Arm pressed against the chest
  • Stiff knee
  • Pointed foot
  • Stiffness in the arms, fingers or legs

CAN SPASTICITY BE TREATED?

There are many strategies and treatments for spasticity to help you recover, return to work and regain function. In order to achieve the best results possible, a mixture of therapies and medications are often used to treat spasticity. Ask a healthcare professional about the best treatment plan for you. Some of the options include:

  • Braces. Putting a brace on an affected limb
  • Exercises. Range-of-motion exercises
  • Stretching. Gentle stretching of tighter muscles
  • Movement. Frequent repositioning of body parts
  • Medications. Medications are available to treat the effects of spasticity
  • ITB Therapy. A programmable, battery-powered medical device that stores and delivers medication to treat some of the symptoms of severe spasticity
  • Injections. Injections block the chemicals that make muscles tight
  • Surgery. Surgery on the muscles or tendons and joints may block pain and restore movement

TIPS TO LIVE WITH SPASTICITY

Managing spasticity with assistive devices, aids and home adaptations can help ensure your safety and reduce the risk of spasticity-related falls. Physical and occupational therapists will recommend the appropriate aid(s) as well as safety procedures, maintenance and proper fit. Some modifications in your home to improve safety include:

  • Ramps
  • Grab bars
  • Raised toilet seats
  • Shower or tub bench
  • Plastic adhesive strips on the bottom of the bathtub
  • Braces, canes, walkers and wheelchairs may help you move about freely as you gain strength.

Always follow rehabilitation therapists’ recommendations regarding limitations and safety needs.

Spasticity Resources:

  Spasticity Checklist

  Faces of Stroke and Spasticity

  Spasticity Animated Video       Spasticity Infographic

 

  Tweet to Beat Spasticity

  Mobility Brochure

 

ADDITIONAL RESOURCES

Source: Spasticity | Stroke.org

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[VIDEO] The Blood Brain Barrier – BrainFacts.org

 

This video explains the components of the Blood Brain Barrier (BBB), and the importance of the BBB to the brain’s health. It also explains the complications the BBB causes when treating illnesses of the brain.

Learn more about the Blood Brain Barrier in this 2017 Brain Awareness Video Contest entry.

Transcript

What is the Blood Brain Barrier? The neurons in you brain require a very specialized environment to function. As the central processor for all of the body’s functions, any kind of contaminant or pathogen could be disastrous, so your brain needs to take extra precaution. The blood brain barrier is an extra layer of protection surrounding most of the blood vessels in your brain that keeps most toxins out. There are three main components of the blood brain barrier.

The first main component are endothelial cells, which line the walls of your blood vessels. Regular blood vessels also contain an endothelial cell lining, however, in regular blood vessels, there are spaces between those cells to allow particles in the bloodstream can pass through those spaces into surrounding tissue.

The endothelial cells in the blood brain barrier contain the second component, tight junctions, made up of proteins, which fill in the spaces between endothelial cells and block most substances from entering the brain.

The third component of the blood brain barrier are astrocytic end feet formed by astrocyte cells. The astrocytes provide nourishment to your neurons, and transport some of the substances that pass through the blood brain barrier such as glucose, to neurons.

So quick review: Endothelial cells with tight junctions block substances from passing through blood vessels and astrocytes provide nourishment to those cells. The blood brain barrier keeps out most toxins and bacteria, preventing potential harm to neurons. When the barrier breaks down, your brain is vulnerable to all sorts of threats. It can cause or speed up neurodegenerative diseases like multiple sclerosis. So what does the blood brain barrier let in? Generally, smaller molecules that are non polar, or don’t have a charge, are let in. Also substances like glucose and oxygen, which your brain requires to function are let in.

While the blood brain barrier is great at keeping out harmful substances, it is also great at keeping out beneficial substances like medicine. This makes infections or conditions like brain cancer so hard to treat, because the blood brain barrier is so selective and blocks out most medicine. However, scientists have been coming up with novel solutions to open the blood brain barrier to allow medicine into the brain. French scientists found out that sound waves can be used to break down the blood brain barrier. Other scientists have tried to use bubbles to force open the barrier and allow medicine through. While the blood brain barrier can be an obstacle in medicinal delivery it is a vital part of our survival and protects our brain from harm. Thanks for watching.

Source: The Blood Brain Barrier – BrainFacts.org

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[BLOG POST] Brain Computer Interfaces (That Translate Human Thought To Direct Action): Their Evolution And Future

a graphic depicting two brains connected to each other. Two human outlines are shown facing each other. The connection between the two brains is shown via dots.

In the last few years, we have read quite a bit about how technology has allowed our brain to control devices or objects around us without the use of limbs. (If you haven’t, you can read about some examples herehere, and here). Futurism.com, a great website that posts about how human potential can be maximized, has this infographic that explains the basics of Brain Computer Interfaces – the use of technology to translate human thoughts into machine commands. We are seeing the use of BCI more and more with prosthetic limbs but where does it end? Will we able to upload our memories straight from our brain to the cloud in the future? Sky is the limit when it comes to innovation through technology.

Read this infographic to know the types of Brain-Computer Interfaces, their origin, what they have in store for us in the future, and how they can bridge the gap between disabled and able-bodied. Text version of infographic is right below the image.

The Evolution of Brain Computer Interfaces. Text is available in the original post right below the image.

 

Imagine a world where machines can be controlled by thought alone. This is the promise of brain-computer interfaces (BCIs) – using computers to decode and translate human thoughts into machine commands. Here’s a look at the evolution of BCI technology, its current state, and future prospects.

Invasive: Signal-transmitting devices are implanted directly in the brain’s gray matter. This method produces the highest quality signals, but scar tissue build up can cause signal degradation.

Partially Invasive: Devices are implanted within the skull but not within the brain tissues. Produce higher quality signals than noninvasive techniques by circumventing the skull’s dampening effect on transmissions, and has less risk of scar tissue buildup.

Noninvasive: Involves simple wearables that register the EM transmissions of neurons, with no expensive or dangerous surgery needed. This technique is certainly easier, but suffers from poor resolution caused by the skull’s interference with signals.

A Short History of BCI

1924: German neuroscientist Hans Berger discovers neuroelectrical activity using electroencephalography (EEG).

1970: The Defense Advanced Research Projects Agency (DARPA) begins to explore the potential BCI applications of EEG technology.

1998: First brain implant produces high quality signals.

2005: A monkey’s brain is successfully used to control a robotic arm.

2014: Direct brain-to-brain communication achieved by transmitting EEG signals over the internet.

Types of Noninvasive BCI

  • Eye movement and pupil size oscillation
  • Electroencephalography
  • Magnetic resonance imaging and magnetoencephalography

Applications of BCI

  • Direct mental control of prosthetic limbs.
  • Neurogaming – interaction within video game and virtual reality environments without the need for clumsy interface.
  • Synthetic telepathy – the establishment of a direct mental connection or communications pathway between minds.
  • The use of BCI in tele-robotics will allow human operators to directly “link” with robotic machines. – granting us a new way to explore aliens worlds, handle dangerous materials, and perform remote surgery.
  • A wealth of new possibilities for interfacing with computers opens up – including linking to the internet, uploading memories to the cloud, etc.
    It will effectively erase the divide between the disabled and the able-bodied.

Sources:

National Academy of Engineering, Techradar, Brain Vision UK, PLOS ONE

This infographic was originally posted on futurism.com.

Source: Brain Computer Interfaces (That Translate Human Thought To Direct Action): Their Evolution And Future – Assistive Technology Blog

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[VIDEO] Homonymous hemianopia – YouTube

Published on Jul 3, 2017

This project was created with Explain Everything ™ Interactive Whiteboard for iPad.

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[VIDEO] Jebsen Taylor Hand Function Test – YouTube

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[WEB SITE] Traumatic Brain Injury Resource Guide – Neuroplasticity

Neuroplasticity

Source: Traumatic Brain Injury Resource Guide – Neuroplasticity

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[BLOG POST] Brain Injury and Sex: What Happens After a TBI?

By Xavier Figueroa, Ph.D.

http://www.msktc.org/tbi/factsheets/Sexuality-After-Traumatic-Brain-Injury

womens-brainsWhat is the largest sex organ in the body?

The brain, of course! (Followed by the spinal cord ganglia but let’s not judge).

Intimacy, desire, physical contact and pleasure, they are very basic needs in a relationship. Marriages, partnerships and friendships rely on this most basic link. But when a brain injury occurs, changes in desire and drive (hypo- and hyper-sexuality) can become apparent. Energy and mood can also be affected, which can induce a change in libido, interest and desire. Damage to certain portions of the brain may affect your ability to move, reducing spontaneity and self-esteem. Elements of coming to terms with the trauma, such as shock and recovery may take time, as well as recovery from physical rehabilitation. If the injury is chronic, other changes may become apparent, including cognitive and behavioral changes that shift how friends and partner interact with each other.

Much of these changes can occur days, weeks or even months after the injury, even in mild to moderate traumatic brain injuries. Knowing how to identify, adapt and overcome the changes associated with an ABI/TBI is an important part of recovery.

The most important information to take away from this post is the following: you are not alone, you are not abnormal and you will get better. Millions of individuals and couples have gone through the recovery of a brain injury and difficulties with reestablishing a functional sexual relationship. Hang in there.

What the Problem Looks Like

When we talk about sex, we are talking about something that is simple in practice, but complex in execution. Prior to the brain injury, a pattern of behavior between yourself and your partner was established. How you interacted and what you expected prior to and leading to sexual intimacy were established and anticipated. I wouldn’t call it a pattern (that’s not very exciting!), but a role in which you knew which part each one would play.

A brain injury directly affects the biggest and most important sex organ in the human body. It’s no wonder that sexual issues appear in 50-60% of people that suffer a moderate to severe TBI. In a recent article in US News and World Report (Health Day, April 29, 2013; Link) that reported on the study that appeared in NeuroRehabilitation: An International Journal:

‘The study found that 50 percent to 60 percent of people with TBI have sexual difficulties, such as reduced interest in sex, erectile dysfunction, pain during sex, difficulties in vaginal lubrication, difficulties achieving orgasm or staying aroused, and a sense of diminished sex appeal, Moreno said.

The research found that partners of those with TBI experienced personality and emotional changes, and a modification of family roles that can lead to a crisis, Moreno said. “For the spouse, the survivor becomes a different person, a person they do not recognize as the one they fell in love with in the past,” he said. “The spouse becomes a caregiver and this imbalance in the relationship directly affects sexual desire.”’

Even in cases of mild TBI, there are incidences of 25-50% of people experiencing sexual difficulties [1], especially in individuals exposed to bomb-blast injuries. Brain injuries are not mild…they can take a life of their own and totally transform who you are and how you relate to your significant other (spouse, partner or lover). Many of these changes can be divided into 5 major groups:

  • Decreased Desire (Hyposexuality): inability to become interested in sex.
  • Increased Desire (Hypersexuality): inappropriate sexual behavior; constant focus on sex.
  • Decreased Arousal: Difficulty in achieving erection/lubrication.
  • Difficulty or Inability to Reach Orgasm/Climax:
  • Reproductive Changes: Low sperm count; missed periods.

But these are just the changes that occur with sexual interaction (as if that weren’t enough). These are behavioral changes that hide deeper and more profound changes that can occur throughout the body. Changes in sexual desire are like the proverbial canary in the coal mine…it warns you that something is amiss.

That Voodoo That You do…

Damage to the brain can induce a number of changes:

Fatigue/Tiredness

Hormonal Changes

Emotional Changes

Cognitive Changes

Spasticity/Movement Problems

These changes can come from very specific damage to certain areas of the brain, such as your pituitary, the frontal and temporal lobes of the brain. When you get down to it, sex is a very complicated process…neurologically speaking! A number of body systems have to work together to make the engines of desire go vroom…and when one system is not working, then it can cause the engine to misfire and stall.

The Tiny Organ

The pituitary gland is a tiny portion of the brain… but don’t let its size fool you. It is a master regulator of hormones that, when damaged, can diminish your ability to regulate your blood pressure, sleep cycle and hormones.

tiny_organThe function of the pituitary is diverse, as it can affect a number of really important functions:

Hormones secreted from the pituitary gland help control the following body processes:

  • Growth
  • Blood pressure
  • Pregnancy and stimulation of uterine contractions during childbirth
  • Breast milk production
  • Sex organ functions in both males and females
  • Thyroid gland function
  • The conversion of food into energy (metabolism)
  • Water and osmolarity regulation in the body (which affects blood pressure)
  • Water balance via the control of re-absorption of water by the kidneys
  • Temperature regulation
  • Pain relief

If that weren’t enough, this can cascade into disease states that may not seem related to a TBI. One thing that we are seeing with returning veterans is pituitary dysfunction is present and undiagnosed or under diagnosed. Even with hormone or growth factor replacement therapies, a pituitary that is not firing on all cylinders will continue to cause long-term problems. Although changes in sexual interaction are the most visible and can be due to pituitary damage, they warn that the damage is more profound. The Big Organ (the brain) has a lot of functions related to behavior…and when it comes to sex, behavior is key (good or bad).

The Tiny Brain (Hypothalamus)

This portion of the brain, the hypothalamus, is a close neighbor to the pituitary. So close, they are friends with benefits. One of the most important functions of the hypothalamus is to link the nervous system to the endocrine system via the pituitary gland (another name of the pituitary is the hypophysis).

The hypothalamus is more of a region than an actual structure. It is composed of many groups of neurons (called nuclei) that control a wide variety of hormonal secretions and behaviors. In a recent small scale study of severe TBI, it was discovered that ~21% of study subjects suffered from hypothalamic-hypophysial dysfunction. In about 40% of male TBI sufferers, there was a detectable drop in testosterone levels [2], which can affect sexual drive and desire in men. About 15% of all patients with a TBI have some degree of hypopituitarism that can go unrecognized and could be mistakenly ascribed to persistent neurologic injury and cognitive impairment [3].

The reason for the hypothalamic damage being mistaken for neurologic injury and cognitive impairment are due to the very broad effects that the hypothalamus exerts on metabolism and brain function. If the hypothalamus is misfiring, it takes a very involved physician (or physicians), with training in neurology, endocrinology and/or experience with TBI to identify the problem. A lot of systems can malfunction in a brain injury.

The Frontal Lobe

The frontal lobe (in green).

The frontal lobe (in green) • tumblr

In head injuries, damage to the frontal lobe is thought to occur frequently. Car crashes (especially front end collisions, are thought to cause frontal and occipital lobe damage. Damage to the frontal lobe has been reported to cause individuals to behave inappropriately in response to normal social situations. Loud or overly-boisterous exchanges, inappropriate genital touching (in public) or fixation on one subject or person have been reported outcomes after a TBI. Changes in emotional affect (expression of emotions) that are felt may not be expressed in the face or voice. For example, someone who is feeling happy would not smile, and his or her voice would be devoid of emotion. This can be very disconcerting to a partner and can be experienced a loss of affection or interest. How a partner or loved one that is a caretaker of a TBI victim experiences the injury will have a direct effect on their own sexual desire and interest.

Along the same lines, though, the person may also exhibit excessive, unwarranted displays of emotion or poor control of anger. Poor anger management is associated with some forms of frontal lobe damage. Depression is not an uncommon outcome from a head injury, especially if there is frontal lobe damage. Also common along with depression is a loss of or decrease in motivation. Someone might not want to carry out normal daily activities and would not feel “up to it”. Sex might not seem as interesting or motivating.

Those who are close to the person who has experienced the damage may notice that the person no longer behaves like him or herself. The frontal lobe is the same part of the brain that is responsible for executive functions such as planning for the future, judgment, decision-making skills, attention span, and inhibition. These functions can decrease drastically in someone whose frontal lobe is damaged. A short list of behavioral changes associated with frontal lobe damage is given below:

  • Agitation
  • Explosive anger and irritability
  • Lack of awareness and insight
  • Impulsivity and disinhibition
  • Emotional lability
  • Self-centeredness
  • Apathy and poor motivation
  • Depression
  • Anxiety
  • Inflexibility and obsessionality
  • Sexual problems

Frontal lobe damage is only one part of cerebral cortex, but is the most common type of cortical damage due to a TBI. Other parts may be damaged as well. Frontal lobe damage is common and better associated with impulse and emotional control, making sufferers act completely out of character and unable to control or edit themselves or their responses.

Putting it Together

So, after reading all of this, what does it do for you? How does this help you re-establish the emotional, sexual and intimate relationship you wish with your partner? As a caretaker, or as a sufferer, the TBI is a big elephant in the room. It exists; it takes up space in your life, even though it can’t be seen. The person you knew is not present…they have not come back from their injury and they might not come back. Some do recover, others do not. But you can still create a new bond, a new relationship and a new life. And you can fight to repair the damage to the brain.

There are limited options for therapy in current medical practice. Mostly, it is focused on developing new skills, relearning old ones, developing coping skills or taking medications. That’s just for the TBI sufferer, not the caretaker(s). The complexity and variety of problems that pop-up when dealing with a brain injury are truly staggering and expensive. Fortunately, the majority of mild-to-moderate TBI’s do recover. Patience and persistence in therapy are required in order to make a recovery.

Unfortunately, for a portion of all TBI sufferers, recovery may take years. That is a long-time to wait. Therapies that help to re-build the brain connections (neuroplasticity) or restore blood flow to the brain hold promise for restoring function again. Hyperbaric oxygen therapy (HBOT) is one such therapy that has a good number of clinical studies to support its use for chronic TBI and PCS [4-9]. Near infra-red and infra-red technologies show promise for a TBI therapy, as well [10-13].

Nutritional support, such as Omega-3 fatty acids (DHA and EPA), has shown the ability to reduce the long-term neuroinflammation associated with a TBI [14-16] and help with white matter repair. Other nutritional therapies may exist to help mediate repair in a TBI.

The take home message is that there are potential therapies that are being developed to help treat the neurological damage of a TBI. Take heart that the “new normal” for yourself or your loved one may not need to be permanent.

  1. Wilkinson, C.W., et al., High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury. Front Neurol, 2012. 3: p. 11.
  2. Kopczak, A., et al., Screening for hypopituitarism in 509 patients with traumatic brain injury or subarachnoid hemorrhage. J Neurotrauma, 2014. 31(1): p. 99-107.
  3. Pekic, S. and V. Popovic, Chapter 18 – Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections, in Handbook of Clinical Neurology, M.K. Eric Fliers and A.R. Johannes, Editors. 2014, Elsevier. p. 271-290.
  4. Boussi-Gross, R., et al., Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury – Randomized Prospective Trial. PLoS One, 2013. 8(11): p. e79995.
  5. Wolf, G., et al., The effect of hyperbaric oxygen on symptoms after mild traumatic brain injury. J Neurotrauma, 2012. 29(17): p. 2606-12.
  6. Harch, P.G., et al., A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma, 2012. 29(1): p. 168-85.
  7. Lin, J.W., et al., Effect of hyperbaric oxygen on patients with traumatic brain injury. Acta Neurochir Suppl, 2008. 101: p. 145-9.
  8. Shi, X.Y., et al., Evaluation of hyperbaric oxygen treatment of neuropsychiatric disorders following traumatic brain injury. Chin Med J (Engl), 2006. 119(23): p. 1978-82.
  9. Wright, J.K., et al., Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen. Undersea Hyperb Med, 2009. 36(6): p. 391-9.
  10. Grillo, S.L., et al., Non-invasive infra-red therapy (1072 nm) reduces beta-amyloid protein levels in the brain of an Alzheimer’s disease mouse model, TASTPM. J Photochem Photobiol B, 2013. 123: p. 13-22.
  11. Gkotsi, D., et al., Recharging mitochondrial batteries in old eyes. Near infra-red increases ATP. Exp Eye Res, 2014. 122: p. 50-3.
  12. Quirk, B.J., et al., Near-Infrared Photobiomodulation in an Animal Model of Traumatic Brain Injury: Improvements at the Behavioral and Biochemical Levels. Photomedicine and Laser Surgery, 2012. 30(9): p. 7.
  13. Naeser, M.A., et al., Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study. JOURNAL OF NEUROTRAUMA, 2014. 31: p. 10.
  14. Pu, H., et al., Omega-3 polyunsaturated fatty acid supplementation improves neurologic recovery and attenuates white matter injury after experimental traumatic brain injury. J Cereb Blood Flow Metab, 2013. 33(9): p. 1474-84.
  15. Lewis, M., P. Ghassemi, and J. Hibbeln, Therapeutic use of omega-3 fatty acids in severe head trauma. Am J Emerg Med, 2013. 31(1): p. 273 e5-8.
  16. Hasadsri, L., et al., Omega-3 fatty acids as a putative treatment for traumatic brain injury. J Neurotrauma, 2013. 30(11): p. 897-906.

Disclaimer: I am not a medical doctor. I am not giving medical advice, diagnosis or treatment recommendations. The posts on this blog are my opinion. If you are thinking of following or using any of this information for any health related conditions, I would recommend you talk to your physician and seek guidance and help. I try to be as meticulous as possible in the information I use for these posts. I look for potential therapies that are low-risk/high impact. There are no guarantees, but knowledge is power and self-direction can lead you to uncover and do incredible things.

Source: Brain Injury and Sex: What Happens After a TBI? | Brain Health & Healing Foundation

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[WEB SITE] 9 1/2 Need-to-Know Facts About Traumatic Brain Injury

9 1/2 Need-to-Know Things About Traumatic Brian InjuryAn estimated 5.3 million Americans — about 2 percent of the U.S. population — currently have a long-term or lifelong need for help with everyday activities due to traumatic brain injury (TBI). (1) Many believe this number to be low as it only takes into account the number of reported injuries to hospital emergency rooms and by health care professionals. We’ve compiled the top 9 1/2 things to know about traumatic brain injury, it would have been 10 but the last 1/2 was left off because memory is often affected by traumatic brain injury.

Multimedia

  1. A traumatic brain injury is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. You do not need to lose consciousness to sustain a concussion.
  2. 1.7 million people sustain a TBI each year in the United States. By the numbers, every American has more than a 1:300 chance of sustaining a traumatic brain injury each year. (2)

  3. The three groups at highest risk for traumatic brain injury are children (0-4 year olds), teenagers (15-19 year olds), and adults (65 and older). (2)

  4. Estimates peg the number of sports-related traumatic brain injuries as high as 3.8 million per year. (2)

  5. Using a seatbelt and wearing a helmet are the best ways to prevent a TBI.

  6. Males are almost twice as likely as females to sustain a TBI.

  7. A concussion is a mild brain injury. The consequences of multiple concussions can be far more dangerous than those of a first TBI. (3)

  8. The area most often injured are the frontal lobes that control thinking and emotional regulation.

  9. A blow to one part of the brain can cause damage throughout.

9 1/2. Most people do make a good recovery from TBI.

If you found this useful, please share with family and friends or leave a comment below if you think we’ve left something off.

References:

  1. Centers for Disease Control. http://www.cdc.gov/traumaticbraininjury/pdf/BlueBook_factsheet-a.pdf
  2. Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2006.
  3. Cifu, David, MD. eMedicine.com. www.emedicine.com/sports/TOPIC113.HTM.

Source: 9 1/2 Need-to-Know Facts About Traumatic Brain Injury

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[BLOG POST] Recognizing the Signs of PTSD After Stroke

Post-Traumatic Stress Disorder (PTSD) is a condition that runs its victims down emotionally and physically. Though most frequently linked to combat veterans and sexual-assault survivors, PTSD can present itself following any traumatic experience, and that includes medical emergencies. Following a stroke and its resulting medical treatment, it is common for patients to feel overwhelmed.

 

According to a study published in the journal PLoS ONE in June of 2013, almost one quarter of patients who survive a stroke will suffer from PTSD. Unfortunately, it is common for the symptoms of PTSD following a stroke to go unnoticed; due to the intense nature of physical recovery, the psychological hardship associated with it can lead to increased risk for heart disease or another stroke.

 

What is PTSD?

After experiencing or witnessing a traumatic event, such as a medical emergency, natural disaster, or an assault, it is difficult to adjust to everyday life again. Some people may struggle with relaxing or sleeping, have flashbacks or unsettling memories, or feel constant anxiety.

This psychological reaction is common and very frustrating. The good news is that it typically diminishes, and life returns to normal over the course of weeks or months, depending on the severity of the event. If a patient is experiencing these mental health symptoms for longer than a few weeks or months, whether constant or in waves, it is possible that they may have PTSD.

 

Symptoms of PTSD After Stroke

It is important to know the signs and symptoms of PTSD so that you can recognize them in a patient or loved one you are caring for after a stroke. Common symptoms of PTSD include experiencing a traumatic event over and over again, having nightmares, or being unable to stop thinking about it. To add to these extremely uncomfortable experiences, victims can also feel  general, unyielding anxiety and try to avoid reminders of the event that started their suffering. They can also be tortured with feelings of self-doubt or misplaced guilt after a stroke or other traumatic event, a state of hyperarousal, or feeling overly alert.

If you are worried that a patient or family member is suffering from PTSD, ask them questions such as:

  • Are you having nightmares?
  • How are you coping?
  • How does this make you feel?

These questions can help the patient discuss their symptoms and improve the likelihood of psychological recovery.

 

TIA and PTSD

Transient Ischemic Attack (TIA), also known as a mini stroke, can increase the likelihood of developing PTSD because the fear of having a stroke may become overwhelming. According to a study published in the American Heart Association journal Stroke, about one third of TIA patients develop signs of PTSD. Approximately 14 percent of TIA patients also experience a drop in physical quality of life, with 6.5 percent of patients experiencing a drop in mental quality of life.

 

Treating PTSD

There are ways to relieve the strain of PTSD. Treatment for PTSD may include medication, psychotherapy, or both. Patients experiencing signs of PTSD should see a trained and qualified mental health professional as treatments may vary from patient to patient.

Medications

A mental health provider or psychiatrist may prescribe antidepressants to patients struggling with PTSD. Antidepressants have been shown to relieve the symptoms of anger, sadness, and overwhelming worry better than other available medications.

Psychotherapy

Sometimes referred to as “talk therapy,” psychotherapy can take place in a one-on-one capacity or in a group setting. Talk therapy is the process of speaking with a mental health professional and can encompass the discussion of PTSD symptoms alone or the effect such symptoms may be having on a patient’s life.

PTSD can sometimes wreak havoc on a person’s social, family, or professional life. To help heal the damage, a mental health professional may combine multiple forms of psychotherapy to address any and all issues a patient may be having with the aftermath of a stroke or TIA. Most often, psychotherapy lasts six to twelve weeks, but it is not unusual for it to take longer to address each patient’s symptoms and struggles. Patients are encouraged to involve family and friends in their recovery because having the extra support can improve the speed and efficiency of mental recovery from a stroke.

 

Finding Relief

PTSD can plague individuals who experience or witness a traumatic event. Medical emergencies are often traumatic, so it is common for survivors of stroke to suffer from PTSD; survivors of TIA can develop PTSD because they may be scared of suffering another mini stroke or of having a full-fledged stroke.

Symptoms can be very taxing on survivors and heartbreaking for their families to see. Fortunately, there are effective treatments for PTSD, including antidepressants and talk therapy with a mental health professional. If you are experiencing PTSD, it is important that you communicate how you feel with your doctor, family, and friends, as a strong support system can help you find the relief from psychological pain that you deserve.

Source: Recognizing the Signs of PTSD After Stroke | Saebo

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[WEB PAGE] What Is PTSD? – PTSD: National Center for PTSD

What Is PTSD?

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time.

What factors affect who develops PTSD?

PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control. For example, having a very intense or long-lasting traumatic event or getting injured during the event can make it more likely that a person will develop PTSD. PTSD is also more common after certain types of trauma, like combat and sexual assault.

Personal factors, like previous traumatic exposure, age, and gender, can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.

What are the symptoms of PTSD?

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

There are four types of symptoms of PTSD (en Español), but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

  1. Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
  2. Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
  3. Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.
  4. Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.

Can children have PTSD?

Children can have PTSD too. They may have symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

  • Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
  • Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
  • Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.

What other problems do people with PTSD experience?

People with PTSD may also have other problems. These include:

  • Feelings of hopelessness, shame, or despair
  • Depression or anxiety
  • Drinking or drug problems
  • Physical symptoms or chronic pain
  • Employment problems
  • Relationship problems, including divorce

In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.

Will people with PTSD get better?

“Getting better” means different things for different people. There are many different treatment options for PTSD. For many people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense. Your symptoms don’t have to interfere with your everyday activities, work, and relationships.

What treatments are available?

There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist. There are different types of psychotherapy:

  • Cognitive behavioral therapy (CBT) is the most effective treatment for PTSD. There are different types of CBT, such as cognitive therapy and exposure therapy.
    • One type is Cognitive Processing Therapy (CPT) where you learn skills to understand how trauma changed your thoughts and feelings. Changing how you think about the trauma can change how you feel.
    • Another type is Prolonged Exposure (PE) where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
  • A similar kind of therapy is called Eye Movement Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.

Medications for PTSD

Medications can be effective too. SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are also used for depression, are effective for PTSD. Another medication called Prazosin has been found to be helpful in decreasing nightmares related to the trauma.

IMPORTANT: Benzodiazepines and atypical antipsychotics should generally be avoided for PTSD treatment because they do not treat the core PTSD symptoms and can be addictive.

Visit Site —> What Is PTSD? – PTSD: National Center for PTSD

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