Posts Tagged brain injury

[BLOG POST] 5 Things Every TBI Survivor Wants You to Understand – HuffPost

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March is National Brain Injury Awareness Month, and as promised, I am writing a series of blogs to help educate others and bring awareness to traumatic brain injuries (TBI).

1. Our brains no longer work the same. 
We have cognitive deficiencies that don’t make sense, even to us. Some of us struggle to find the right word, while others can’t remember what they ate for breakfast. People who don’t understand, including some close to us, get annoyed with us and think we’re being “flaky” or not paying attention. Which couldn’t be further from the truth, we have to try even harder to pay attention to things because we know we have deficiencies.

Martha Gibbs from Richmond, VA, suffered a TBI in May of 2013 after the car she was a passenger in hit a tree at 50 mph. She sums up her “new brain” with these words:

Almost 2 years post-accident, I still suffer short-term memory loss and language/speech problems. I have learned to write everything down immediately or else it is more than likely that information is gone and cannot be retrieved. My brain sometimes does not allow my mouth to speak the words that I am trying to get out.

2. We suffer a great deal of fatigue.
We may seem “lazy” to those who don’t understand, but the reality is that our brains need a LOT more sleep than normal, healthy brains. We also have crazy sleep patterns, sometimes sleeping only three hours each night (those hours between 1 and 5 a.m. are very lonely when you’re wide awake) and at other times sleeping up to 14 hours each night (these nights are usually after exerting a lot of physical or mental energy).

Every single thing we do, whether physical or mental, takes a toll on our brain. The more we use it, the more it needs to rest. If we go out to a crowded restaurant with a lot of noise and stimulation, we may simply get overloaded and need to go home and rest. Even reading or watching tv causes our brains to fatigue.

Toni P from Alexandria, VA, has sustained multiple TBI’s from three auto accidents, her most recent one being in 2014. She sums up fatigue perfectly:

I love doing things others do, however my body does not appreciate the strain and causes me to ‘pay the price,’ which is something that others don’t see.  I like to describe that my cognitive/physical energy is like a change jar. Everything I do costs a little something out of the jar.  If I keep taking money out of the jar, without depositing anything back into the jar, eventually I run out of energy. I just don’t know when this will happen.  Sometimes it’s from an activity that seemed very simple, but was more work then I intended. For me, like others with TBIs, I’m not always aware of it until after I’ve done too much.

3. We live with fear and anxiety. 
Many of us live in a constant state of fear of hurting ourselves again. For myself personally, I have a fear of falling on the ice, and of hitting my head in general. I know I suffered a really hard blow to my head, and I am not sure exactly how much it can endure if I were to injure it again. I am deeply afraid that if it were to take another blow, I may not recover (ie, death) or I may find myself completely disabled. I am fortunate to have a great understanding of the Law of Attraction and am trying my hardest to change my fears into postive thoughts with the help of a therapist.

Others have a daily struggle of even trying to get out of bed in the morning. They are terrified of what might happen next to them. These are legitimate fears that many TBI survivors live with. For many, it manifests into anxiety. Some have such profound anxiety that they can hardly leave their home.

Jason Donarski-Wichlacz from Duluth, MN, received a TBI in December of 2014 after being kicked in the head by a patient in a behavioral health facility. He speaks of his struggles with anxiety:

I never had anxiety before, but now I have panic attacks everyday. Sometimes about my future and will I get better, will my wife leave me, am I still a good father. Other times it is because matching socks is overwhelming or someone ate the last peanut butter cup.

I startle and jump at almost everything. I can send my wife a text when she is in the room. I just sent the text, I know her phone is going to chime… Still I jump every time it chimes.

Grocery stores are terrifying. All the colors, the stimulation, and words everywhere. I get overwhelmed and can’t remember where anything is or what I came for.

4. We deal with chronic pain.
Many of us sustained multiple injuries in our accidents. Once the broken bones are healed, and the bruises and scars have faded, we still deal with a lot of chronic pain. For myself, I suffered a considerable amount of neck and chest damage. This pain is sometimes so bad that I am not able to get comfortable in bed to fall asleep. Others have constant migraines from hitting their head. For most of us, a change in weather wreaks all sort of havoc on our bodies.

Lynnika Butler, of Eureka, CA, fell on to concrete while having a seizure in 2011, fracturing her skull and resulting in a TBI. She speaks about her chronic migraine headaches (which are all too common for TBI survivors)

I never had migraines until I sustained a head injury. Now I have one, or sometimes a cluster of two or three, every few weeks. They also crop up when I am stressed or sleep deprived. Sometimes medication works like magic, but other times I have to wait out the pain. When the migraine is over, I am usually exhausted and spacey for a day or two.

5. We often feel isolated and alone.
Because of all the issues I stated above, we sometimes have a hard time leaving the house. Recently I attended a get together of friends at a restaurant. There were TVs all over the room, all on different channels. The lights were dim and there was a lot of buzz from all of the talking. I had a very hard time concentrating on what anyone at our table was saying, and the constantly changing lights on the TVs were just too much for me to bear. It was sensory stimulation overload. I lasted about two hours before I had to go home and collapse into bed. My friends don’t see that part. They don’t understand what it’s like. This is what causes many of us to feel so isolated and alone. The “invisible” aspect of what we deal with on a daily basis is a lonely struggle.

Kirsten Selberg from San Francisco, CA, fell while ice skating just over a year ago and sustained a TBI. She speaks to the feelings of depression and isolation so perfectly:

Even though my TBI was a ‘mild’ one, I found myself dealing with a depression that was two-fold. I was not only depressed because of my new mental and physical limitations, but also because many of my symptoms forced me to spend long periods of time self-isolating from the things — like social interactions — that would trigger problems for me. With TBI it is very easy to get mentally and emotionally turned inward, which is a very lonely place to be.

Also, check out my other blogs on the Huffington Post:
“Life With a Traumatic Brain Injury”
“Life With a TBI: March is National Brain Injury Awareness Month”

I invite you to join my TBI Tribe on Facebook if you are a survivor, or loved one of a survivor.

Source: 5 Things Every TBI Survivor Wants You to Understand | HuffPost

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[VIDEO] The Effects of Brain Injury on Memory – YouTube

How does brain injury affect memory? Learn about memory impairment following brain injury in this video featuring NeuroRestorative’s Tori Harding. Following a brain injury, the deeply embedded and long-term memories usually remain intact while short-term memory may significantly be affected. Learn about the three memory system areas and strategies that can help a survivor improve their memory.

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[WEB SITE] Can Ritalin Help Mitigate Brain Injury Symptoms?

 Question

My 54-year-old husband sustained a TBI when he fell asleep at the wheel while driving and hit a tree. The doctors say that he damaged all four parts of his brain. It’s been more than one and a half years and he’s still totally dependent on me to take care of him. Do you think Ritalin would help stimulate his brain?

Answer

Methylphenidate (Ritalin) is one of the commonly used brain stimulants in people who have suffered traumatic brain injury. It increases chemicals in the brain that have a stimulating effect (norepinephrine and dopamine).

After traumatic brain injury, doctors commonly prescribe Ritalin for low arousal or initiation, poor attention and concentration, depression, and slow processing speed. There is research that shows that Ritalin may speed recovery early after moderate to severe TBI. There is also research showing that Ritalin increases mental processing speed after TBI, which can improve memory function in some people.

All medications have side effects and the risks need to be weighed against possible benefits. One of the good things about the standard formulation of Ritalin is that it is short acting so if side effects occur they wear off in a few hours. Some potential side effects include keeping you up at night (if taken too close to bedtime), decreased appetite, headache, irritability, and paranoia.

In your husband’s case, his doctor needs to look at why he is so dependent. If arousalattention, and/or initiation are playing a significant role, a stimulant can be considered. Careful monitoring for effects and/or side effects is needed when starting this medication and it should only be done by a doctor who has experience in caring for people with traumatic brain injury. Ritalin and most stimulants are controlled substances and will require frequent visits to the doctor for prescriptions.

Source: Can Ritalin Help Mitigate Brain Injury Symptoms?

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[BLOG POST] 5 Tips on Caring For An Individual With a Brain Injury

When a loved one or family member suffers a brain injury, you may take the role of caregiver – a role that can be exceptionally challenging. At the very least, it’s a stressful time that can call on all of your mental and physical resources and abilities.

The fact is, few injuries are as devastating as a severe brain injury. The person who suffers one may behave, think, and see the world differently than he or she did prior. Providing support and being their caregiver, is often a delicate, demanding task. Here are some suggestions to keep in mind.

1.Structure is Vital

Maintaining a structured environment is essential for providing care to someone who’s suffered a brain injury. The structure will minimize potential issues by providing the individual a consistent, dependable way of life. It provides you (the caregiver) with a disciplined approach that accounts for most variables and inevitable challenges that may arise. It also means maintaining a schedule that provides as much activity as the patient can handle, without becoming overly fatigued.

2. Communication

Knowing what not to say to a person with a brain injury is just as important as knowing what to say. Keep these tips in mind:

  • Don’t tell them they’re not trying hard enough – Apathy, not laziness, is common after a brain injury. Recognize apathy and take steps to treat it.
  • Understand the invisible signs – A person with a brain injury often suffers from hidden signs such as fatigue, depression, anxiety, etc., and saying that they “look fine” to you is belittling.
  • Don’t complain about having to repeat yourself – Almost everyone who suffers a brain injury will experience some memory problems. Becoming frustrated that you have to repeat yourself only emphasizes the issue.
  • Remain patient when they’re not – Irritability is a common sign of a brain injury and it can come and go without reason. If you are always pointing out their grumpiness, it doesn’t help the situation.
  • Don’t remind them how much you do for them – The person may already know how much you do for them – and feels some guilt about it – or may not understand at all (depending on the severity of their injury).

3. Educate Yourself

Become involved in their recovery during the rehabilitation process. Doing so enables you to have a clear understanding of struggles the person will face, and strategies that you can implement at home to lessen the impact of these problems.

4. Be Aware of Changes in Behavior

Check with your physician whenever you notice any behavioral changes in your loved one, or person you are caring for. Seizures can develop after a brain injury and occur several months, or even years after the injury occurred. Your physician may recommend anti-seizure medications.

5. Take Time for Yourself

It can be easy to ignore personal fatigue and frustration while you’re caring for someone with a brain injury. Taking time for yourself, calling on the help of others, joining a caregiver support group – all are ways that can assist you from becoming physically and emotionally exhausted. Above all, be kind to yourself and give yourself credit for all that you do.

Source: 5 Tips on Caring For An Individual With a Brain Injury | MVRRH

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[WEB SITE] Vision and Rehabilitation After Brain Trauma (Part 1)

Vision and Rehabilitation After Brain Trauma (Part 1)

Eric Singman, MD, PhD, Health.mil

This is part one of a three-part article published to health.mil.

Vision Problems After Brain Injury

Visual problems following brain trauma are frequent and often complex. It is probably easiest to define the problems based upon how they affect incoming visual information (i.e., the afferent visual pathways) or the outflow of information to the visual organs (i.e., efferent visual pathways). Afferent defects include reduction in visual acuity, visual field, color vision, contrast sensitivity, comfort (usually as it relates to glare), and higher level visual processing, including recording of visual memory and comprehension of visual stimuli. Efferent defects include reduction of the ability to visually pursue a target, focus the lens inside the eye, train the two eyes onto a single target, maintain gaze once a visual target is obtained, and open and close the eyelids. In this three part series, we will describe 1) damage to the afferent visual pathways, 2) damage to the efferent visual pathways, and 3) the role of the neuro-ophthalmologist in visual restoration and rehabilitation.

The Afferent Visual Pathway and How Brain Injury Can Affect It

Light enters the eye through the cornea, the clear window of the eye. The cornea provides the majority of the focusing power of the eye, and is an extremely poor refractive surface, but with a healthy tear film it becomes nearly perfect. Brain injury often causes dry eye thereby reducing visual acuity. Furthermore, brain injury patients often lose an adequate blink response or develop lagophthalmos, the inability to completely close the eye. Dry, unprotected corneas are subject to scarring and infection.

Trauma to the brain often entails injury that can also shake or directly damage the eye along with the rest of the body. Patients suffering a blast injury can experience rapid elevation of pressure in the chest, which is then transmitted by the blood vessels to the retina, the neural tissue lining the inner wall of the eye. This is the tissue which converts light rays into the electrical impulses that are sent to the brain. The retinal blood vessels can rupture from the sudden increase in pressure and cause bleeding within the retina, a condition called Purtscher’s retinopathy. The free blood inside the eye can cause significant scarring and loss of vision.

Direct head trauma can also cause the eye to move too quickly and/or too far relative to the fixed structures in the eye socket. This can cause stretching or shearing of the optic nerve, the nerve that carries visual information to the brain. This traumatic optic neuropathy often can result in permanent visual impairment. Multiple direct head traumas also are a risk factor for problems within the eye itself, such as detachment of the retina from the back of the eye, or formation of a cataract, a clouding of the natural lens.

Trauma to the head invariably is associated with some degree of trauma to the neck, a risk factor for damage to the blood vessels of the neck. Injury to the wall of an artery can cause it to bulge (i.e., form an aneurysm) or separate from its inner lining (i.e., arterial dissection). Either situation can lead to abnormal blood flow to the visual pathways of the brain. Furthermore, either condition can cause the vessels to physically compress portions of the visual pathways, such as the nerves that control the eye muscles or the nerves that bring visual information to the brain. This could result in double vision or in reduction of visual acuity and visual field, respectively.

It has been demonstrated that the world we see is formed into a map upon our brain, specifically onto an area called the visual cortex. This map is organized such that the image of the world is inverted and reversed; the left side of our brain sees what is to the right of where we look and the right side of the brain sees light from the left of where we gaze. Furthermore, visual information emanating from above our visual point of interest is transmitted to the lower portion of the visual cortex while the upper portion of the visual cortex maps the visual world below the object of regard. It is for this reason that damage to the visual cortex causes loss of peripheral vision rather than simply loss of visual clarity.

While we do not know how visual memories are created or stored in our brains, it is known that brain injury slows the acquisition and processing of visual information and impairs the formation of visual memory. Recent research has suggested that these impairments may result from stretching or shearing of nerve fiber bundles after head injury. Sadly, higher level visual processing failure is often particularly difficult for a patient to express. Neuropsychologists have proven to be critically important for the diagnosis of these problems and for guidance in directing rehabilitation efforts.

Source: Vision and Rehabilitation After Brain Trauma (Part 1)

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[WEB SITE] Finding Strategies That Work After Brain Injury

Question

My brother had a brain injury six years ago and has been through several periods of rehabilitation to where he now jokes he could be a therapist! He can list all the strategies he is supposed to use to get somewhere on time — like his job — he just doesn’t do them or says they don’t help. Can you give me some insight here?

Answer

To begin, one has to consider whether being on time to work is meaningful to your brother. If he enjoys his job and recognizes the implications of being late, then chances of helping him figure out how to get there on time are much better.

Assuming this is the case, your brother’s dilemma is not uncommon after a brain injury. Many everyday activities, such as being somewhere on time, actually involve a number of different skills. It’s important to first figure out what skills are involved so you can choose strategies that are likely to work.

Let’s take your example of getting to work on time and list just some of the cognitive skills and steps that play a part and could be causing his problems:

 

  • Attention: What time is it, anyway? Am I on time or running late? Am I doing what I am supposed to be doing right now (or getting distracted by a TV show)?
  • Memory: What time do I have to be at work today? What needs to be done before I leave the house?
  • Initiation: Do I get started on each step of my routine in a timely manner?
  • Planning: Do I have enough time to get ready? Are my clothes ready? Have I planned enough time for transportation?
  • Problem-solving: What do I do if I’m running late? What if my transportation falls through? What are my other options? Do I have enough time to go back if I forgot something like my ID badge, lunch, or newspaper?

 

Breaking down an activity into more specific component skills can often help tease apart where the true difficulty lies. Then a strategy that promotes success (generally, one that builds on his strengths) can be developed by the person with brain injury and if needed, a significant other. If this proves too difficult, some consultation with a cognitive rehabilitationspecialist may be useful as well. And remember, any new strategy often requires a lot of practice to make it a habit, especially after brain injury.

Finally, if your brother does not seem motivated, the discussion needs to be about what is important to him. If getting to work on time is not one of his priorities, what is it that he wants to accomplish?

Click here to go to About Ask the Expert.

Source: Finding Strategies That Work After Brain Injury

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[WEB SITE] Why social work is so important for brain injury survivors

A brain injury can leave people disabled, unemployed and at risk of broken relationships. Advanced practitioner Simon Eggington explains why this makes social work so important for this client group.

Picture credit: Monkey Business Images/Rex Features

Why do people who have suffered brain injury need social work support?

Many brain injured survivors experience cognitive, behavioural, psychological and physical disability and subsequently exhibit degrees of impaired social competence, including disinhibited speech, impulsivity, poor social skills and judgement. They can be egocentric, appearing (often unintentionally) selfish and self-centred. A scenario of vulnerable relationships and breakdown followed by the inability to forge new relationships is all to common. Consequently, many brain injury survivors experience social isolation, low mood/depression and poor quality of life. When combined with barriers to returning to work or gaining work, resulting in reduced income and/or reliance upon the benefits system, the outcome for many can be very poor indeed. Social work support can prevent or reduce the impact of this downward spiral.

What does a specialist brain injury social worker do?

The Sheffield brain injury social work team support survivors through the three main components of the brain injury care pathway: the acute stage, sub-acute stage (involving inpatient rehabilitation) and into the community.

Family members become incredibly distressed at the scale of impairment, disability, behaviour and personality change that emerge following brain injury. For many it will be catastrophic, others may downplay their loved one’s level of disability and will remain unrealistic in potential goal attainment and recovery. Mutual adjustment can be delayed in these cases and it is the brain injury social worker’s role to confront these issues, offering a solution-based empathic intervention.

Offering support to families is essential as, in many cases, they will be the brain injury survivor’s only lifelong support network following rehabilitation discharge. Social workers offer families brain injury education to aid adjustment by raising awareness and providing behavioural management strategies, supported by the appropriate multi-disciplinary team members.

The brain injury team provides information, emotional support, onward referrals, signposting and community care assessments of need. The psychosocial goals-focused intervention provided by Sheffield head injury rehabilitation centre works to maximise the brain injured survivor’s potential, whilst supporting ongoing adjustment. The brain injury social worker is an integral element of this process and represents a positive example of health and social care working together.

How did you get into brain injury social work?

I had trained and qualified as a social worker in 1990 and gained work as a hospital social worker. I had always been intrigued by the workings of the brain – especially when ‘brains get broken’ (as a client described it). The interest grew as I was referred more clients with brain injury. I was aware that we had a well-established dedicated team at that time in Sheffield and would ask for their advice about cases I was working. Social workers often work with those who experience social disadvantage and marginalisation, but when working with brain injury survivors I became very aware of this and the effects of multiple loss, believing I could make a difference. When a position became vacant in the brain injury team in 1997 I applied and was successful. Fifteen years later I’m still here albeit in more of a management role.

What are the key skills required of a brain injury social worker?

• Good interpersonal skills and clear communication requiring flexibility in their application when meeting the wide and varied needs and presenting behaviours of brain injury survivors;
• Skills in managing difficult behaviour, including understanding its origins, responding appropriately and being assertive and clear regarding boundaries with survivors who can exhibit disinhibited, impulsive behaviour;
• De-escalation skills – often brain injury survivors misinterpret information and react in a disproportionate way;
• Assessment and interviewing skills – many brain injury survivors lack insight and awareness and will subsequently understate their needs, and there is a real requirement for knowledge and tenacity in gaining detailed information about eligible need to formulate an in-depth assessment;
• Good coordination skills – brain injury survivors will often have many agencies working alongside, including health, social care, housing, substance misuse and police, and the brain injury social worker needs to be able to co-ordinate these services in establishing a robust support network.

What are the three biggest challenges of working with people who have had a brain injury?

  1. There needs to be recognition that working with brain injury survivors can be intense and time consuming, particularly working with those who are isolated, vulnerable and have co-morbidity issues, such as mental health, substance misuse, or a history of violence or risk taking. Lack of insight increases vulnerability levels as brain injury survivors will put themselves repeatedly at risk. The social worker is often the only support available and will need to be proactive as many fall under eligibility criteria or refuse to engage with services.
  2. Navigating and supporting brain injury survivors through the welfare rights system is challenging work as their disability can be largely hidden. Many brain injury survivors have difficulty in articulating the effects of their disability, they fail the employment and support allowance medical assessment and consequently get pushed back into the job market prematurely or inappropriately, causing anxiety, depression and anger. Without the support of a social worker many misrepresent or deny they have a disability due to poor awareness and insight problems. Others have reduced tolerance and refuse to fully co-operate, leading to benefit realignment or withdrawal.

  3. Returning to work can be challenging for brain injury survivors. Often the issue is not to do with physical disability as work environments can usually be adapted, but more to do with adjustments that will satisfy the effects of cognitive impairment and psychological need. Employers need to be supported in recognising the need for a structured and organised day, alternative training methods, consistent work space, need for memory prompts and clear boundaries regarding appropriate office behaviour. When brain injury isn’t recognised as a unique disability by employers or the brain injury survivor doesn’t make their needs apparent, gaining and retaining employment becomes problematic.

Simon Eggington is advanced practitioner in the Sheffield brain injury social work team

 

Related articles

Young people with brain injuries ‘more likely’ to commit crimes

Diary of a social worker supporting adults with brain injury

Source: Why social work is so important for brain injury survivors | Community Care

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[BLOG POST] Emotional/Behavioural Changes after Brain Injury – Part 2

Continued from Part 1 From The Toronto Acquired Brain Injury Network. My comments are in bold like this. Emotional/Behavioural Changes Impulsivity and disinhibition A person may lose their ability to control their actions or their speech. This problem often goes hand in hand with lack of awareness, and the person may not be aware of […]

via Emotional/Behavioural Changes after Brain Injury – Part 2 — Broken Brain – Brilliant Mind

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[WEB SITE] How Brain Tissue Recovers Following an Injury – Neuroscience News

DECEMBER 16, 2016

Summary: Findings could lead to new treatments to help regeneration following trauma.

Source: Kobe University.

A research team led by Associate Professor Mitsuharu Endo and Professor Yasuhiro Minami has pinpointed the mechanism underlying astrocyte-mediated restoration of brain tissue after an injury. This could lead to new treatments that encourage regeneration by limiting damage to neurons incurred by reduced blood supply or trauma. The findings were published on October 11 in the online version of GLIA ahead of print release in January 2017.

When the brain is damaged by trauma or ischemia (restriction in blood supply), immune cells such as macrophages and lymphocytes dispose of the damaged neurons with an inflammatory response. However, an excessive inflammatory response can also harm healthy neurons.

Astrocytes are a type of glial cell, and the most numerous cell within the human cerebral cortex. In addition to their supportive role in providing nutrients to neurons, studies have shown that they have various other functions, including the direct or active regulation of neuronal activities.

It has recently become clear that astrocytes also have an important function in the restoration of injured brain tissue. While astrocytes do not normally proliferate in healthy brains, they start to proliferate and increase their numbers around injured areas and minimize inflammation by surrounding the damaged neurons, other astrocytes, and inflammatory cells that have entered the damaged zone. Until now the mechanism that prompts astrocytes to proliferate in response to injury was unclear.

The research team focused on the fact that the astrocytes which proliferate around injured areas acquire characteristics similar to neural stem cells. The receptor tyrosine kinase Ror2, a cell surface protein, is highly expressed in neural stem cells in the developing brain. Normally the Ror2 gene is “switched off” within adult brains, but these findings showed that when the brain was injured, Ror2 was expressed in a certain population of the astrocytes around the injured area.

Ror2 is an important cell-surface protein that regulates the proliferation of neural stem cells, so the researchers proposed that Ror2 was regulating the proliferation of astrocytes around the injured areas. They tested this using model mice for which the Ror2 gene did not express in astrocytes. In these mice, the number of proliferating astrocytes after injury showed a remarkable decrease, and the density of astrocytes around the injury site was reduced. Using cultured astrocytes, the team analyzed the mechanism for activating the Ror2 gene, and ascertained that basic fibroblast growth factor (bFGF) can “switch on” Ror2 in some astrocytes.

bFGF is produced in the injured zone of the cerebral cortex. Ror2 expression is induced in some population of the astrocytes that receive the bFGF signal, restarting their proliferation by accelerating the progression of their cell cycle. NeuroscienceNews.com image is credited to Kobe University.

This research showed that in injured brains, the astrocytes that show (high) expression of Ror2 induced by bFGF signal are primarily responsible for starting proliferation. bFGF is produced by different cell types, including neurons and astrocytes in the injury zone that have escaped damage. Among the astrocytes that received these bFGF signals around the injury zone, some express Ror2 and some do not. The fact that proliferating astrocytes after brain injury are reduced during aging raises the possibility that the population of astrocytes that can express Ror2 might decrease during aging, which could cause an increase in senile dementia. Researchers are aiming to clarify the mechanism that creates these different cell populations of astrocytes.

By artificially controlling the proliferation of astrocytes, in the future we can potentially minimize damage caused to neurons by brain injuries and establish a new treatment that encourages regeneration of damaged brain areas.

Visit Site —> How Brain Tissue Recovers Following an Injury – Neuroscience News

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[WEB SITE] Stress Management Following Brain Injury: Strategies for Families and Caregivers – brainline.org

Few illnesses, injuries, or diseases result in the devastating and overwhelming damage which accompanies brain injury. The individual who sustains a brain injury is no longer the same person: he or she may behave differently, think differently and in fact be a different person than before the injury. The differences may be large or small; they are differences nonetheless. And when one member of a family changes, the entire family changes. Learning to live with these changes produces stress for the injured individual and for those who care for that person. The steps outlined below can help lessen the burden and convert stresses into challenges which can be managed and overcome.

1. Identify stress

Sounds easy. We all know when we are stressed. It’s obvious. All your friends and relatives can tell you what is stressing you. We professionals are particularly guilty of telling you what to do and how to do it. Everyone is full of good advice and solutions to your problems. The solutions may range from putting the injured person in an institutional setting to developing some backbone and shouldering responsibility the way you should.

Don’t allow others to identify your stress for you. Stress is cumulative and it is very personal. What might be stressful to one individual is not stressful to another. What is stressful to you at one point in time may not be stressful at another point. Only you can determine what is stressful to you. And you can only do that by experience. Spend time each day analyzing what has stressed you in the past 24 hours.

Avoid making moral judgments about stress. Stress in itself is neither good or bad. It is simply a situation in which your body’s usual, customary, and habitual responses don’t work and you must develop new responses. Your responses are neither good nor bad. You are not a bad person because you become angry at the injured person’s behavior, because you become tired in a very short period of time, because you yell at your kids or another individual, because you don’t want to change sheets or clothes one more time today. Accept your body’s response without making judgments.

  • Make a list of each and every thing you do on a daily basis. Be very specific, including even the smallest activity. Include things you do for everyone, not just the injured individual. Then rate each one on a scale of 1 – 10 with 1 being “no stress whatsoever, enjoyable” and 10 being “a root canal without anesthesthia would be much more fun.” Do not show this list to anyone else. Be honest.

2. Reduce or eliminate stressors

Also sounds easy but this is the hardest part. I am always amazed at the number and amount of things people do because they have always done them. Absolutely irrational, meaningless things; things which reduce the time available to enjoy life; things which 24 hours later have no meaning at best, negative meaning at worst.

Do only those things which have meaning to you and to others; do them quickly, efficiently and only once. If you’re dreading doing something for five hours before you have to do it, you have wasted five hours and still have to do it. Whenever possible, live in the present; avoid the future and the past since you have no control over them anyway.

Once you have your list of things you do regularly, decide which of those you rated over 5 truly need to be done. Objectively need to be done. Those things where life would not continue if they weren’t done. Probably they need to be done. I won’t argue with you. I will argue that YOU need to do them. Answer each of the following questions:

  • Do they have to be done the way they are usually done? Can the person with the brain injury do them? Can another family member do them? Can a volunteer do them? Can a group of people do them? Can you reduce how often they need to be done? Can they be done at a different time of day? Can they be done in a way that makes them enjoyable (or at least less stressful)?

3. Replace stressful things with pleasant things

It is truly surprising to me to see individuals who successfully reduce or eliminate stressful situations from their life and within a week add a whole new list of activities which are equally stressful. It seems as if they thrive on stress but everyone who lives with the consequences of brain injury knows that it is not true. The problem is that, unless you actively substitute pleasant activities for unpleasant ones, the time will rapidly fill with equally (or perhaps even more) unpleasant activities.

If you have lived with the consequences of brain injury beyond the acute medical stage you know how difficult it is to allow yourself the luxury of enjoyment and relaxation. There never seems to be enough time for you. Simply and solely because you don’t make the time. Every human being is a like a pitcher; you can only serve out what was poured in to you. You cannot continue to give without replacing what you give. If others are not able to give to you, then you must give to yourself. When was the last time you gave yourself a present? A simple, inexpensive present like a walk in the park, dinner with a friend, sleeping late in the morning, maybe even breakfast in bed. Or, even worse, when was the last time you allowed someone else to give you a present of time or assistance?

You may think I have lost touch with reality because you KNOW that other people are not willing to help. You have tried them in the past and they never came through for you. They make empty offers which you know they don’t mean. Besides, many of your friends from before the injury no longer call or visit. You’re alone in this. There is no help. You have tried time and time again. I suggest you try again, making sure you are specific about the kind of help you need, when you need it, what is involved, how often you need it, and, most importantly, what you are willing to do in return. Your family and friends can only give to you if you continue to give to them. They are also pitchers that need to be refilled. When they see you totally stressed out, they assume the same thing will happen to them if they try to help. Try being specific and giving in return. It’s worth the effort.

Another alternative is to try new things in which the entire family can participate. Families sometimes fail to try new activities and stick with the tried-and-true favorites. Try to discover new activities in which the effects of the deficits of the head injured person are minimized. Many injured individuals are able to do things they once did as a child or young adult because those activities rely on old rather than new learning. Experiment with activities which can be enjoyable for everyone and feel less like work for the caregiver.

4. Maximize the capabilities of the person with the brain injury

It is sometimes very difficult to determine just what the injured individual is capable of doing. Therefore, family members may do things for the injured individual that could and should be done independently. Persons who sustain head injuries continue to improve for years, learning new skills or new ways to do things. If the family doesn’t “catch up,” they keep on “doing for” rather than letting go. It often feels easier to do it yourself than to work regularly for a long term goal of independence or at least less dependency. But that strategy doesn’t reduce the stress for the injured individual or for the family.

Many family members have explored or even participated in newly-developed cognitive retraining programs. They usually begin with a detailed analysis of the person’s current capabilities and limitations. From this analysis the treatment program is developed and the progressive steps toward increased independence are outlined. Families can do the same kind of analysis. Start with your stress list. Pick the 5 most stressful situations which require that something be done for or to the injured individual. Evaluate what parts of that task the injured person could do himself/herself. ASK THE INJURED PERSON FOR SUGGESTIONS ON THIS PART OF YOUR TASK. That person may well have very good ideas of how the task could be accomplished more independently. Consider the following ways to accomplish the task:

  • Change the time at which the task is done. If fatigue is a problem, for example, switch the task to an earlier time in the day or after a rest period. Schedule more time for completion of the task. Try to set up all necessary materials so the person can do the task independently. Use written instructions, photographs or picture demonstrations to allow the person to complete the task independently.

Basically I am suggesting you experiment to determine what the injured individual can do. You lose nothing by trying and the injured person may well be much more capable than others (or you) think. Give the person a chance. Give yourself a chance to reduce your stress. Allow the injured individual and the family to grow in a more relaxed atmosphere of increasing independence.

Source: Stress Management Following Brain Injury: Strategies for Families and Caregivers

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