Sports Related Concussions - Helpful Information for Parents and Coaches

The number of children playing sports who have suffered from concussions has doubled in the last decade. It is thought that the reason for this may be that children are bigger than they once were and sports, even for young people, has become more competitive. As a result, it is even more important for parents and coaches to be aware of what to look for to avoid future problems.

Concussions in young children can create serious health risks from temporary memory lapses to brain swelling. It is especially a concern because concussions in children may not be recognized or noticeable immediately following an injury.

A second concussion before complete healing of the first has taken place can cause a condition known as second impact syndrome. The results of this are children run a risk of developing post-concussion syndrome.

Even a mild bump can cause a concussion in a young child. A child (or anyone for that matter) can suffer a concussion without losing consciousness and, in fact, fewer than ten percent do. And unfortunately, concussions can not be identified on Xrays or CT scans. They can be the result of not only a knock to the head but the sudden jarring to any part of the body which causes the brain to move suddenly within the skull. Also, it's important for all those involved to remember that the effects of multiple concussions can be cumulative.

The symptoms of a concussion are:

- A headache or feeling of pressure in the head; nausea or vomiting; dizziness; blurred vision; sensitivity to light or noise; a feeling of being dazed; irritability; memory or attention problems; confusion; ringing in the ears; slurred speech or mood changes.

- With younger children, the signs may be stomach pain or a feeling of being upset.

If any of these signs are evident, it is important to immediately seek medical attention. These symptoms can last for seven to ten days and possibly even longer depending on the severity of the hit, if there has been a previous concussion and if there was, if it was very long ago.

Rest is the most important treatment for a concussion. Rest means no physical activity and no mental exertion which includes no school, no computer games and even no television. Children should not attempt to return to play sports until they have been given the go ahead by their doctor.

The Canadian Paediatric Society published a statement on sports related concussions in children making recommendations based on current data and expert opinion, with guidelines on concussion management. They believe that it should be based on each athlete's symptoms and recovery and that a graduated return to play should be followed. They recommend also that doctors be encouraged to be conservative when managing children and adolescents with sports related concussions.

There is more awareness now that a bump on the head may not just be a bump on the head, but a concussion. And more people now are aware that a concussion is in actual fact, a brain injury. So as parents and coaches, knowing this, means that we must be even more diligent with our children when they are playing sports.

How to Protect Our Youth Against Head Injuries and Concussions

How can we protect our children against concussions and head injuries? Common sense should tell us that we do all within our power to ensure that our children are protected from these injuries. It is important that parents and coaches remember and are aware that while children are young, their brains are still forming. Their vulnerability to concussions and head trauma is much greater than that of an adult because a child's head, for the first eight years of their lives, is disproportionately large for the rest of their body and their necks are weak.

Many doctors and neurosurgeons are calling for rule changes in many of the sports so that concussions can be eliminated. It is suggested that while helmets protect the skull, they don't protect the brain from slamming against the skull during a collision or a hit on the head. It's the brain being slammed that causes a concussion.

Tackle football is one of the sports at the top of the list that is putting young people at tisk although hockey and even soccer follow closely behind in the concussions experienced by young people. Sports has a lot to offer children but there must be a way to safeguard our young people. It is difficult to do because many children like the roughness of these sports as do many of the coaches and parents but it must be done if we are going to properly protect our children.

Little is known as yet, or at least not that has been officially verified, concerning the results of head hits received by a nine or ten year old child and how they will manifest in someone twenty-five or thirty or even fifty years old.

However, I can tell you what I have experienced. At sixteen years of age, I was involved in a car accident, receiving a concussion which knocked me out momentarily. I appeared not to have any symptoms except recurring headaches. However, I must point out that this was before concussions were considered as serious as they now know them to be. When I was thirty-five, I suffered my first mild seizure. I did not experience another one for some years when I again had another mild seizure. Several years later, while working in an extremely stressful work environment, I began experiencing seizures, still mild, but on a regular basis, sometimes as many as six a day. The result was that I was forced to leave this place of employment and went on medication. That was a few years ago and have been fortunate not to have experienced anymore seizures.

Now my concussion was a result of a car accident and therefore, unavoidable. But to let our children play sports that have the known likelihood of them receiving a concussion or other head trauma, to me seems irresponsible. Perhaps as parents and coaches, we can institute rules to protect them against this risk. I believe that if we don't do something, we are being negligent.

Some of the recommendations that have been suggested for children and young people are: touch football instead of tackle football; no heading the ball in soccer for young children and, no full body contact while playing hockey.

Our children are important to us and so their safety, for not only today, but also their safety for the future, must be of prime importance to us as parents and coaches.

Brain Injuries and Concussions in Young Athletes

Recent studies have indicated that brain injuries and concussions in youth correlate with a history of crime later in life. If this is the case, it is important to be aware of our young people's head injuries and concussions when they play contact sports such as football.

A retired doctor from Dover, New Hampshire recently proposed there be a ban placed on high school football because of the potential dangers to young people. He said in football, the head is used as a battering ram. Obviously controversial, some say then we should keep our children from riding in a car because that can be potentially dangerous as well.

However, common sense states that the dangers of brain injuries and concussions are significantly higher while playing football or other high contact sports. Especially considering that in a single season, a football player can receive over 900 hits. And it is estimated that one out of four players suffer a concussion during the season with many more going unreported because they don't want to be taken out of the game.

Added to that is the recent study finding that head injuries for young people with maturing brains can cause some 'misfiring' and disruption in the development of self-restraint, social judgment and impulse control. Studies have also shown that the prevalence of brain injuries among prisoners is as high as sixty percent with a large percentage having the potential to re-offend. After further studies, it was discovered that juvenile offenders suffering brain injuries were significantly higher than the group who didn't have injuries.

Perhaps it is time that parents, coaches and the school system find a way to identify and manage concussions and brain injuries early so that young people receive the right neurorehabilitation.

Football is a collision sport but perhaps there are also ways to make it safer for young people to play. Hockey in recent years has also become more aggressive. Maybe it's time to think about the potential consequences to our youth playing these sports and the concern about the increasing number of concussions and possible brain injuries.

Possibly some of the following rules for children playing sports cvould be considered: - That they no longer use their heads as battering rams while playing football.

- That tackle football be abandoned. At the high school level of football, impact is often 20 times the force of gravity.

- No more heading in soccer for young people.

- And no more full body checking for children playing hockey.

We shouldn't doom our children to a life of crime, lifetime cognitive problems or early Alzheimers because of our love for these contact sports or for the hope of a university scholarship. A child's safety should always be first and foremost.

Concussions - Children and Adolescents

A concussion changes how the brain works. It can be only a bump, a jolt or a significant blow to the head or body which will cause the brain to move rapidly back and forth. Even a mild bump to the head can be serious in some cases and particularly in young children.

Symptoms can show up immediately or not until sometime later. Symptoms are: being dazed, confused or forgetful; having a headache; feeling nauseated or vomiting; problems with dizziness or balance and clumsy movements; being sensitive to noise or light; memory problems; being unconscious, even briefly; one pupil being larger than the other; feeling drowsy; having seizures or any other changes in behavior.

If a concussion is suspected, the child should immediately be pulled from the game so that an assessment from a health care professional can be obtained before the child is allowed back to play. Rest is imperative if a child or teenager has suffered a concussion. Brains take time to heal so as to avoid further complications. Until a young athlete has completely recovered from the first concussion, a second injury is more likely to occur. This should be avoided because second, and subsequent concussions take longer to heal than the first ones.

My young seven year old grandson plays soccer and loves the sport. He recently told me proudly that he had 'headed' the ball to keep it from going into the goal. He had no ill effects from this but I do believe that in a child so young, even 'heading' a ball is something to be aware of and concerned about, in spite of the fact that soccer isn't considered to be one of the rougher sports.

The International Conference on Concussion in Sports believes that when it comes to concussions in children and teens, different treatment is required. If a concussion has been identified, it is important that the child or teenager not be allowed to return to the field to play, not to go to school and definitely not to engage in cognitive activities of any kind until they are completely healed. Cognitive rest is particularly important for a successful recovery.

It is important also that children and teenagers be strictly monitored during this recovery time. There is a realization that the developing brains of young people require special consideration. They may need a long period of rest with a more gradual return to activities than adults require.

The onus therefore, is on parents and coaches to ensure that these safeguards are heeded when it comes to children and adolescents. And it is good to remember that it is better to miss a game than to miss a season, or worse still, to live with lifetime consequences because of not taking the proper care when it should have been taken.

Strokes - An Acquired Brain Injury

In order to optimize stroke recovery, it is paramount to have early diagnosis and appropriate and immediate medical care. When this is done, a patient's treatment and rehabilitation can begin.

Recognizing the symptoms of a stroke are important though so that immediate action can be taken. They are: numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; trouble seeing out of either one or both eyes; difficulty walking, dizziness or loss of balance, or a sudden, severe headache.

If a stroke is suspected you must immediately call 911 or an emergency response system in your area. There is a very limited window from the onset of symptoms to when therapy can successfully be used. To determine whether it is a stroke or not, have the person smile. Their face should move symmetrically. Also ask them to raise both arms so that any evidence of paralysis will be evident, and to speak a simple sentence. While waiting for the ambulance to arrive, the person should lie flat to allow the blood to flow to the brain. If there are definite stroke symptoms, do not give them aspirin in case there is any bleeding.

Once a stroke patient has become medically stable, rehabilitation can begin which will initially teach him/her how to manage their own personal hygiene, feed themselves, get in and out of bed and to use the bathroom on their own.

Further rehabilitation may include a physical therapist, occupational therapist, speech and language pathologist, psychologist and recreation therapist depending on the severity of the stroke. This type of rehabilitation will help to promote independence in their daily lives. Responses to treatment and their overall recovery will, however, depend mainly upon themselves and their own personalities. Part of early recovery is spontaneous which are natural abilities that will automatically begin to come back, especially during the first few weeks following a stroke. But significant recovery can be made even years after a stroke. Rehabilitation works best when stroke survivors and their families work together.

After rehabilitation in either a formal rehabilitation program or as individual services, the person will eventually be able to return to community living. During this stage they may have to learn to do common tasks in a different way. It may be that they will have to use their opposite hand to write or do things they originally did with their other hand. They may require velcroe on their shoes instead of laces or if it has been a serious stroke, they may require the use of a wheelchair.

Strokes can affect the body, mind and feelings. And because a stroke is an acquired brain injury, they may have many of the same deficits that those who have suffered a traumatic brain injury have been faced with. They may be unaware of their injury, have problems with their memory, experience lack of judgment and motivation as well as other cognitive problems, and fatigue and depression.

The most important thing in having a successful outcome following a stroke is that there is an early diagnosis, with immediate therapy and treatment. Without early treatment, there is the risk of life-long consequences to the patient such as disabilities that could possibly have been prevented.

Can Brain Injuries and Concussions Age the Brain?

Studies indicate that brain injuries and concussions may have an affect on the way a brain ages, even thirty or more years after the fact. Concussions are a better indicator because there are fewer deficits than those who have suffered from a brain injury.

Early acute findings following an injury are only the tip of the iceberg as researchers discover post-concussion that there is a decline in memory, inability to update their memories, attention difficulties, executive function problems and slowing of movements. These are all indications of the difference between those who have previously had a concussion and those who have not.

Post-concussion symptoms may show, even months or years later as: attention deficits, impulsiveness or irritability, low frustration levels, temper outbursts and mood changes, dizziness and headaches, and learning and memory problems. Brain injuries, depending on the severity, may show additional deficits such as: lack of motivation, problem solving difficulties, cognitive deficits, emotional and behavioral problems, short term memory loss and lack of judgment to name some of them.

As those who have a history of concussions age, they may have difficulty in how quickly they remember names and places, an inability to quickly come up with specific words or to recall events. Research indicates that the concussed brain seems to be biologically older than the non-injured brain. Tests show that a fifty year old who had a concussion, even thirty years previously, has a similar brain to that of an uninjured sixty year old.

There appears to be a premature aging of the brain as a consequence of past concussions, however, even a lone event can impact the brain. To ward off this accelerated deterioration of the brain, it is important to do brain training, i.e.: exercising, reading, puzzles and learning new things.

Considering the seriousness of even a single concussion, those who play football are at an even greater risk. Football players receive an average of 950 hits to the head each season. Hockey players, and all those who play contact sports, are also at risk.

Because of these high risk factors, researchers are conducting tests to determine whether those who have received concussions or brain injuries have an increased chance of getting Alzheimer's Disease when they get older. Dementia is also considered more of a risk for those who have received either injury.

The lesson to be learned in this is to do all that can be done to avoid concussions or brain injuries by taking safety precautions in everything that is done. But if one should occur, it will be important to do all that is required to become healthy again by resting, taking rehabilitation and following a doctor's instructions.

Brain Injuries and Communication

Communication involves not only speaking but listening to words, observation of facial expressions, hand movements and comprehension. Many brain injury sufferers have difficulty with communication because of cognitive and memory problems as well.

Often brain injury sufferers will have difficulty in maintaining a topic in conversation, they may use an inappropriate tone of voice, i.e.: possibly speak in a belligerent manner; have difficulty determining the difference between a sarcastic remark and a serious comment, or have a problem understanding a fast-paced conversation. Others may have difficulty taking their turn in conversations or may not be able to find the correct word to express themselves in either speech or the written word, or they may have difficulty understanding not only conversations but with comprehension when reading books or newspapers. Following the story line in a movie may also be hard for them to do. Some may also become overemotional when communicating with others or be unable to respond to another person's body language.

For others, their thinking skills may have been affected which will in turn make communication difficult. Memory problems will also affect their communication abilities because the thread of a conversation may be lost. Or they may have trouble concentrating if there are distractions. Their ability to process what others are saying if they speak too quickly may make understanding more difficult as well. Organizing their thoughts and becoming confused easily may hinder communication also. Social situations may become more difficult because of communication problems. In some cases, they may place the blame for these difficulties on the person to whom they are speaking.

Other problems with brain injuries and communication which may exist are: difficulty when given too much information at one time and therefore, have an inability to understand the meaning; have difficulty paying attention when others are speaking; problems following instructions; may take jokes, etc. too literally, or they may repeat the same thing over and over again.

Difficulties with communication after suffering a brain injury will depend on the severity of the injury and what part of the brain was affected. What can the brain injured sufferer do to help himself/herself?

They can make an effort to remain calm when understanding is a problem; they can ask others to speak more slowly; plan ahead what they want to say; turn off the television and other distractions; repeat what has been said to them to make sure they understand, and ask for an explanation if they don't.

What can others do to assist someone when communication is a problem? Give them time to speak, don't make them feel rushed, don't speak for them, encourage them, don't force anyone to speak if they are reluctant to do so, use short and simple sentences, don't interrupt them when they are speaking and include them in general conversations.

Communication is probably one of the most important skills we can possess. Cognitive and memory difficulties can affect communication so it may be necessary to deal with those problems first in order to be able to resolve communication difficulties. Just like it takes a village to raise a child, the brain injury sufferer will require assistance with his/her communication problems as well.

Brain Injuries and Self-Awareness

A brain injury can make it very difficult for sufferers to understand their impairments and limitations. Often a lack of self-awareness is a form of denial but it can be much more than that too.

Self-awareness is the ability to understand the difference between the deficits they now have and their pre-injury self. A lack of self-awareness makes it difficult to understand what their current deficits mean to their future and to the goals they may have once had.

It is the ability to monitor and correct behavior; self-awareness is not only the ability to recognize and understand their cognitive deficits but their physical and social behaviors as well. Those with this deficit cannot perceive themselves in an objective manner, often not realizing that they, in fact, have any limitations or impairments.

This lack of self-awareness will cause them to be unmotivated and they will see no need for their therapy and rehabilitation. They may lack judgment or make unrealistic goals which will make rehabilitation difficult. A lack of self-awareness may appear to be a denial of their deficits.

Those with more self-awareness will be willing participants in their rehabilitation and therefore, will be more successful in coping with their deficits and becoming integrated into the community. However, with self-awareness there is the possibility of depression when realization of their disabilities is fully recognized.

Many with brain injuries are more aware of their physical disabilities than they are of their social and emotional ones. Memory deficits can also affect the ability to be self-aware because they may not remember their behaviors and think of themselves as they were pre-injury not realizing there's a difference.

To help someone who may be suffering from lack of self-awareness, allow them to do what may be beyond their capabilities, when it is safe to do so, giving them the opportunity to learn through trial and error situations. Give them realistic and supportive feedback in a non-judgmental way, help them to set realistic goals and develop plans towards accomplishing these goals, and have them keep track of their progress.

When lack of self-awareness is a problem, making mistakes and looking for others to blame is common. Failing in their job performances may be another example of their lack of awareness. Therapists will try to get those lacking self-awareness to see the difference between their perceived levels of functioning and their actual levels of performance.

The deficit of impaired self-awareness is the most difficult to overcome and can take a long time before improved self-awareness will be noticeable in brain injury survivors.

Memory Strengthening Techniques

Our brain's memory improves with mental and physical stimulation. With this stimulation we are protected against cognitive decline.

The ability of our brain to adapt and rewire itself, growing new neurons, will continue even into old age by constant mental and physical stimulation. The old adage, 'use it or lose it' applies as much in the case of our brains as with anything else.

It is important to retain a lifelong curiosity and to accept challenges such as learning an instrument, a new language or any other new skills. To force our brains to think differently and therefore create new neurons, do activities such as switching hands to do things like dialing the phone, using your computer mouse, eating, brushing your hair or teeth, applying face cream, setting the table or even while doing physical exercises.

Working with modeling clay encourages our brains to grow new connections by promoting agility and hand-brain coordination. Learning to play Scrabble, chess or a complex card game such as bridge, where strategy is involved, will help too. Travel also helps to expand the brain because we are seeing and learning new things. Everything new we expose ourselves to and learn not only protects us against cognitive decline but helps to strengthen our memories as well.

Using both our physical and emotional senses at the same time in unexpected ways is another technique that will help to strength and grow new brain cells. An example of this could be doing familiar things such as getting dressed and eating, with your eyes closed. Or perhaps listen to classical music and write poetry.

Other things that will help stimulate the brain and assist with memory are to watch less television and read more, on a daily basis. Physical exercise also stimulates the brain. Walking is extremely good for the brain because it increases blood circulation and the flow of oxygen causing cerebral blood vessels to grow. This improves memory skills, learning abilities and concentration. Studies indicate that walkers are less likely to experience age-related memory loss. Running is also an extremely good brain boosting activity but may not be particularly suited to most seniors.

Other techniques to boost memory is to memorize a series of numbers and then repeat them backwards, increasing the speed of repetition each time. Or make lists of things and memorize, i.e.: shopping lists and things to do lists. It is important when memorizing, or in everyday situations, to involve all of your senses. The more senses involved, the more likely and easier it is to remember. Studies indicate that the brain will become stagnant if it doesn't continue to learn new things. There is no threshold for what the brain can learn as it can keep rewiring itself with each additional piece of information it learns.

Additionally, studies show that those who are socially active have slower rates of decline in memory and cognitive performance. Connections with others opens up avenues for learning.

To keep our brains agile, the techniques of continuous lifelong learning along with mental stimulation and physical activity will help prevent cognitive decline as well as memory loss.

The Therapeutic Benefits of Music for Those With Brain Injuries

Studies have shown that music can promote new neural connections for those with brain injuries. As well, music has been proven to trigger memories possibly assisting with memory loss as well as cognitive and physical functions.

For help in overcoming such syumptoms as short term memory loss and impaired decision making skills, music is being considered as a therapy for those with brain injuries. Some therapists are introducing neurological music therapy to their patients because studies indicate that music can promote new neural connections.

Music assists with speech and language skills, physical functioning and social interaction. Because music is a whole brain function, it can affect emotional well-being and assist with motor skills such as learning to walk again or in using fine motor skill development to manipulate small objects. Music offers an opportunity for those suffering from brain injuries or strokes to relate to others. It can increase confidence and self-esteem as well as help to reuild self-identity.

. Therapy includes listening to familiar music, relating to the rhythm and tempo, singing songs or playing an instrument such as the drums. Music therapy is used in a clinical setting by a qualified therapist to stimulate brain functions, encourage social interaction, emotional and cognitive requirements and to rehabilitate speech and language disabilities.

Music therapy is believed by many to improve the quality of life. Studies indicate that rhythmic auditory stimulation will help with movement, musical improvisation is good for emotional expression, and singing can assist with speech. Listening to music is believed to be a benefit in controlling pain and in increasing auditory processing. It is also believed that music therapy will help prevent depression as well which is often a serious symptom of brain injuries.

In many of these therapy sessions traumatic brain injury patients each have a drum and match rhythms and tempo set by the instructor. Studies of music therapy have indicated that there have been improvements that when used have also been instrumental in relieving frustrations for those sufferers who have exhibited displays of violence as one of the symptoms following a head injury.

Congresswoman Gabby Giffords, who suffered a brain injury from a sniper's bullet, was given music therapy. This therapy has been credited with her ability to speak again by training her brain to use a less traveled pathway. The ability of the brain to be able to do this is called neuroplasticity. It is believed that few other things activate the brain as extensively as music.

Music therapy helps to promote new pathways in the brain (called neuroplasticity) thereby creating new neural connections which in turn increase the brain's ability to heal. Studies indicate that music is a great step towards brain injury recovery.

New Drug May Treat Brain Injuries, MS, Parkinson's and Alzheimer's

Studies indicate that a new drug recently tested may reduce or prevent neurological damage. It is expected that it will protect users against cognitive impairments.

The new drug, MW151 and MW189, is expected to reduce inflammation in the brain. Neuroinflammation is increasingly believed to play a major role in the diseases of Multiple Sclerosis, Parkinson's, Alzheimer's and dementia as well as brain injuries and strokes. Besides preventing the development of these neurological diseases, it is believed it will reduce the neurological damage caused by closed head traumatic injuries and strokes especially if introduced within a certain time period.

These two drugs are believed to prevent the damaging overproduction of brain proteins which contribute to the development of degenerative neurological diseases as well as the neurological damage caused by brain injuries and strokes. It is believed that it will protect against the damage associated with learning and memory deficiencies as well as other cognitive impairments.

The therapy time window, however, is considered critical. A study indicated the best time for the drug to be given someone with a brain injury or stroke is three to six hours following the injury. By doing so, it could possibly prevent future problems such as cognitive impairments or the risk of epileptic seizures.

Studies indicate that by giving the drug, a pill taken orally, before symptoms become readily apparent, in the case of Alzheimer's Parkinson's or Multiple Sclerosis, may be a promising therapeutic strategy for these neurodegenerative diseases. It is considered to be a preventative drug when given during the early stages of a neurological disease before the disease progresses. If taken in the early to middle stages, it will help to reduce inflammation.

The first human Phase I climical trial has been done on the drug and it has been found to be safe in humans. Researchers are now waiting for funding in order to begin further clinical trials. Those working with the drug feel that it will best be used in combination with current therapies targeting neurodegenerative disorders, brain injuries and strokes.

The body has proven itself to have great repair mechanisms if given a chance. If a pill can control, prevent or reduce cognitive impairments, then the body has a chance to rebuild itself. This healing process can be done when obstacles have been removed from the body and mind. But it can also heal with determination and sometimes just because that's what the body does. But with neurodegenerative diseases, etc. extra help with this drug will go a long way in warding off these debilitating diseases and eliminating the devastating results of head injuries.

It is believed that this drug will help many people in their fight against these neurodegenerative diseases, brain injury and strokes saving many sufferers and families from hopelessness and despair.

The Importance of Adequate Care for Those With Brain Injuries

For those who have had a brain injury, life becomes a challenge. It is imperative for those who have suffered a brain injury to receive adequate care because sustaining such an injury will increase the challenges they will face throughout their lifetime. A brain injury can lead to the development of neurodegenerative and neuroendocrine disorders. And because of the limitations they will face day-to-day, psychological treatment will likely be an advantage, if not necessary also. In the case of a broken leg, you know it will repair itself in about six to eight weeks but there is no predictable end in sight for those who have suffered from brain injuries.

Doctors and therapists can encourage the brain's plasticity with proper therapy which will encourage the growth of new brain cells. Only stimuli that encourages adaptive functions should be used, therefore a structured rehabilitation environment is important. As patients improve so too will the intensity of the therapy increase. One example of learning correct adaptive behaviors is a patient learning to walk again but who may occasionally lose his balance. It will be necessary for them to learn appropriate reflex actions so as not to hurt themselves when their balance is precarious. For these reasons, specialized rehabilitation settings usually lead to better results.

Many brain injury survivors unfortunately, don't receive adequate care following their injury either because it is not available in their area, they are unable to afford the care or do not have medical coverage, they adamantly refuse further specialized therapy, or they have not been diagnosed as requiring specialized therapies. This is particularly true of the thousands of Iraq and Afghanistan war veterans who have suffered traumatic brain injuries. For them, in some cases it is because Veterans Affairs officials have not determined their diagnosis. However, even following diagnosis, there has been little follow-up for reasons such as computer glitches, insufficient staffing and disorganization.

In many cases, brain injury sufferers not receiving adequate and appropriate care will endure a lifetime of frustration and challenges, not only for themselves but for their families as well. It could also mean a high cost in human life when violence is a result of brain injury, as well as a heavy financial burden to not only the family but to the community as well. Continuing depression and the possibility of suicide are also results of inadequate follow-up care for those with brain injuries.

Lack of adequate medical care and rehabilitation can also possibly lead to higher levels of medical complications, permanent disability, family dysfunction, job loss, homelessness, impoverishment, involvement with crime, drug and alcohol abuse, psychiatric disorders and lost productivity. It can also minimize social interaction within the community.

For those whose family members have sustained a brain injury, fighting to obtain adequate follow-up care for your loved one will ensure a better quality of life for them and for yourself.

Violence With a History of Brain Injury

The link between brain injury and violence is strong. The possibility is even stronger if post traumatic stress disorder (PTSD) has also been a factor.

Studies indicate that there is a correlation between brain injuries and violence. It is suspected that personality changes brought about as a result of a head injury may predispose a sufferer to violent behaviour. The cognitive and behavioral effects of a traumatic brain injury, particularly if it is a frontal lobe injury can cause aggression and/or violent behaviour. According to a recent study, a brain injury can also cause problems in reasoning, impulsiveness and aggression.

The U.S. soldier who is suspected of recently leaving his base in Afghanistan at night and killing sixteen civilians, mainly women and children, in their homes had suffered a traumatic brain injury in 2010. The brain injury occurred while involved in a vehicle roll-over accident while on tour in Iraq. He was treated and returned to duty in December, 2011. Studies show that recovery from brain injuries is not quick. Take a look at Sydney Crosby, the hockey player, and the tough road he has had to travel to recovery.

The additional problem is that many of these soldiers are not only returned to duty while still suffering from their brain injury but many have undiagnosed brain injuries. As well, it is likely that many are suffering from post traumatic stress disorder (PTSD) too.

PTSD is marked by sleep problems, irritability, difficulty concentrating, jumpiness and is often associated with anger, hostility and aggression. Flash backs can trigger an aggressive act meant to ward off a threat. Those with PTSD are more likely to perceive or imagine a threat. Also those suffering from post traumatic disorder may lack empathy, be depressed, aggressive and be unable to grasp the seriousness of a violent act.

An estimated 200,000 soldiers have been diagnosed with a traumatic brain injury since the Iraq and Afghanistan wars began with many more undiagnosed. Because brain injuries impair their judgment, a traumatic brain injury will increase the risk that a sufferer will behave violently.

The frontal lobe portion of the brain influences impulse control, understanding right from wrong and being able to anticipate the consequences of one's actions. The frontal lobe is particularly vulnerable to injury so is the most often affected. It is estimated that nearly forty percent of all TBI sufferers have exhibited violent behaviour compared to only eleven percent of those who have not had a TBI.

A study done of Iraq war veterans who had suffered traumatic brain injuries indicated that they experienced significantly more mental health problems in the years following their injuries, particularly those associated with PTSD. These problems also often lead to drugs, substance abuse and severe depression.

The soldier suspected in the recent massacre was on his fourth combat deployment. Many soldiers have three, four and five combat tours up to a year each in length. And at the height of the Iraq fighting, these tours often lasted as long as fifteen months.

This has to take a huge toll on any soldier even one without a brain injury or PTSD. Studies indicate that a high rate of Iraq or Afghanistan veterans either commit suicide or attempt suicide. Also domestic violence has surged by over thirty percent among military families. This is an unbelievably high human cost of war on many levels - of the needless killing of innocent people such as the sixteen recently killed, on the soldier himself, on his family and on the health care system.

Brain Injuries and Suicide

According to research, many of those who have suffered a traumatic brain injury are at a higher risk for suicide than those in the general population. What are the risk factors and how can they be prevented?

Where brain injuries and suicide are concerned, the following are some of the risk factors: depression, anxiety, post traumatic stress disorder, lower levels of psychosocial functioning, aggressive behavior, and those with poor decision making skills. Other risk factors are panic attacks, issues with anger, memory loss and impaired thinking, substance abuse, a tendency to withdraw from society and impulsive behavior.

Mental health disorders are a major factor contributing to suicides as well as having such pre-injury problems as a seizure disorder, (either pre or post injury), bipolar disease, personality disorder, psychosis,history of psychiatric illness or a history of suicide in other family members.

Other issues relating to the risk of suicide is a feeling of hopelessness, those who have a perception of loss, isolation, poor family relationships, feeling lonely, suffering from lack of initiative, experiencing extreme fatigue, having few friends, no significant other, an inability to get a job, cognitive issues, feelings of low self-worth, feelings of unhappiness and those who are likely to engage in high risk behaviors.

The largest percentage of brain injury sufferers at risk for attempted suicide or suicide are males in the 25 - 35 year age range. Suicides and attempted suicides are particularly high amongst soldiers in the military. The rate has increased despite programs for suicide prevention and intervention particularly since the wars in Iraq and Afghanistan.

In order to help a friend or family member decrease the risk of suicide, what can we do? It is necessary to identify any psychiatric or psychological issues. If any are suspected, contact a Mental Health Association with your concerns. Other issues leading to a high risk situation are economic problems, inability to adjust to their disability, pre-injury problems such as a dysfunctional and chaotic family background and a lower economic status.

It is also important to be aware of any non-verbal behaviors or cues, to maintain contact with the person and be aware of their whereabouts, encourage communication, avoid arguments, help to establish a safety net, let others know of the risk potential, encourage counseling, try to identify triggers that may initiate suicidal thoughts, recognize their moods and to provide alternatives to high risk behaviors.

Most head injury sufferers are definitely not predisposed to suicide. However, if the patient is at high risk, it is important to be aware of this so that measures can be taken to ensure his/her safety.

Tools to Help With Recovery For Brain Injuries

More is being learned about brain injuries all the time as there is more awareness of them. And with awareness comes better ways of assessing injuries and finding tools to assist in recovery.

With both clinical and scientific research, it has been proven that there are benefits with music. It is one of the tools that has been discovered that help benefit those who have been victims of a brain injury. It helps to re-organize the structure of the brain. Music, such as Mozart will help with organizing thoughts, activities and emotions. It also helps with memory, sequencing, concentration, verbal communication, self-esteem, depression and frustration. Music can be used to reeducate and retrain the injured brain. It can help with language and speech problems. It has been been discovered that although a patient may be unable to speak or put several words together to form a sentence, they can sing those same words in a song that is known to them. It has also been shown to help build relationships and facilitate positive behavior. It helps to improve movement in limbs and increases their strength as well.

Music therapy can enhance cognitive skills. Classical music especially increases brain activity but all types of music can be beneficial. There is growing evidence that demonstrate music is a valuable resource tool for those with head injuries. Another of those benefits is that it increases dopamine levels and changes the brain's chemistry. Many professionals working with survivors of brain injury have discovered that music is a powerful tool.

Another tool is the use of technology devices that are being used by virtually everyone but are recently being used in brain injury recovery. They have been found to help survivors, particularly those who have speech difficulties. It allows them to be able to communicate with caregivers, medical professionals and friends, helping them to stay connected with others. Some of these assistive devices offer a voice generated option. These digital devices can help them to relearn simple tasks such as reading. The use of these devices also improves cognition and helps with memory and organizing as well as giving reminders of daily tasks eliminating the necessity of using a diary.

Computers can also be powerful tools in rehabilitation. This is especially true if programs are selected to meet the needs of the brain injury survivor. Introduction to computer use though should only be when the recipient is open to using a computer and not forced if they are adamantly opposed to it.

Another tool that is being used in some instances to treat brain injury and stroke is hyperbaric oxygen therapy (HBOT). It is a high concentration of oxygen within a pressurized chamber. It is considered somewhat controversial as a treatment for brain injuries. However, it is claimed by some that many of the conventional treatment methods are not working. In some cases it is claimed, hyperbaric oxygen therapy can dramatically increase the oxygen carried in the blood stream and therefore assists with recovery.

It was once thought that between six to eighteen months following a brain injury, there could be little hope of recovery. But with more awareness and knowledge of the brain and the discovery of tools that can now be used in rehabilitation, it is now known that a brain injury survivor can continue to improve indefinitely.

Brain Injury, Alcohol and Dementia

Alcohol and substance abuse often follow a brain injury. And the combination of alcohol and a brain injury can lead initially to dementia-like symptoms which could become dementia if there is a continual heavy use of alcohol.

Brain injuries can cause a permanent decline in cognition in the process of thinking, remembering, understanding, reasoning and communication as well as changes in emotions and behavior, depending on the location of the injury. This is even more the case with older patients.

The symptoms of dementia include difficulty in interacting with others, problems with memory, thinking clearly, memory loss, irritability, slowed thought processes, neglecting grooming and hygiene, apathy, psychosis and mood and behavior difficulties. Dementia creates a significant loss of intellectual abilities and can be severe enough to interfere with social and occupational functioning. Someone suffering from dementia will have difficulty solving problems, maintaining emotional control and may have periods of delirium. Dementia is the result of the death of nerve cells.

Alcohol impairs brain functions and abstract reasoning also. For someone who has suffered a brain injury, there is no safe amount of alcohol to drink. Both a brain injury and alcohol affect memory, cognition, reasoning, judgment and executive function. A person who drinks heavily, and consistently over a long period of time, may have brain deficits that will continue even after they are sober, which may lead to dementia.

Heavy drinking can further permanently impair the brain over and above the injuries sustained from the head injury. Even moderate drinking can lead to brain impairment. The influence of alcohol combined with a brain injury can precipitate the potential for dementia depending on: how much and how often a person drinks; how long they've been drinking; their age, level of education, and family history of alcoholism. Heavy consumption of alcohol can result in serious and persistent changes in the brain. The combination of a brain injury and alcohol can significantly impair cognitive abilities, as does dementia.

Often, because of the brain injury, a sufferer may have difficulty seeing the relationship between their behavior and the resulting consequences of their heavy consumption of alcohol, i.e.: they don't understand why drinking is a problem; that they are too drunk to drive; that alcohol is creating a health problem for them; that it creates a problem with their relationships, or in understanding that heavy and consistent drinking can lead to the strong possibility of developing dementia.

It is difficult to deter someone from drinking if they are determined to do so but particularly if they have had a brain injury. It is even more difficult if the consumption of alcohol has been a behavior pattern before their injury as well. But it is important to attempt to do so as continual drinking combined with a head injury has no good outcome.

Multiple Brain Injuries Compound Already Existing Problems

Repetitive head injuries are when someone has sustained a second injury or concussion before the symptoms from the first have been resolved. Multiple injuries over time, regardless of the success of their recovery, can result in functional deficits as well.

Following medical recovery after an injury, there should be rehabilitation to assist in learning the use of adaptives strategies and in applying skills to solve problems. The recovery process can only be measured individually because of the brain's complexity and because no two injuries are the same. This is because each person has a different personality and way of coping, etc. The difficulties resulting from a head injury and the subsequent deficit symptoms could continue for years following such an injury. Follow-up rehabilitation puts the focus on replacing skills and functions that have been lost by working on the deficits. Rehabilitation sometimes may need to be extended for years beyond the initial injury.

Most brain injuries affect more than one aspect of brain based functions. Subsequent injuries can emphasize any lingering deficits from the initial injury and also may increase the risk of long-term damage that affects personality and cognitive abilities. This can accentuate the problems for not only the victim but for his family and the community at large.

A Bill passed recently in the United States was implemented mainly to help young athletes and to increase the awareness of the short and the long-term impact of brain injuries and concussions.

Although it was initially passed with athletes in mind, perhaps it should be used with military personnel who have been involved in combat as well. It has recently come to light that the soldier suspected of shooting sixteen civilians in Afghanistan recently had suffered more than one injury while in Iraq, possibly as many as three. In interviews with family, friends and neighbors, there is every indication that this soldier had displayed no tendencies towards aggression or violence before his injuries.

Studies indicate that injuries such as these change personalities, especially if post traumatic stress disorder (PTSD) has been part of the problem too. So is it any wonder that with multiple concussions or head injuries there is an increasing potential for depression, aggression and violence? Are those in the military properly assessed following a head injury? Are they being given rehabilitation and a proper amount of time to recover before they are sent out on another tour of duty?

Studies indicate that even those with a mild brain injury can have psychological problems such as depression and anxiety, and substance abuse and alcoholism. Then when post traumatic stress disorder is in addition to a head injury, the psychological abilities to respond to issues created by the injury will be further impacted.

When we see a tragedy such as the needless killing of civilians happen, it increases the importance of ensuring that there is full recovery and rehabilitation following a head injury. And also that proper assessment be done not only to determine the injury, and any subsequent injuries, but also to assess the possibility of post traumatic stress disorder being a factor.

Meditation and Your Brain

Researchers report that those who meditate for thirty minutes per day for eight weeks have changes in their gray matter density in the part of the brain associated with memory. Meditation assists with their sense of self and learning abilities as well as memory.

Mindfulness is one technique of meditating. Other meditation styles are Shamatha, Vipassana and Zazen. Mindfulness meditation is based on ancient Buddhist techniques which focus on breathing, emotions or any type of body sensation rather than letting the mind wander. It can reduce blood pressure, increase attention spans and reduce stress.

Those who meditate, researchers have found, have larger brains. Since our brains shrink naturally from aging, meditation could well slow this progress. Meditation helps all areas of the brain so those who have suffered a traumatic brain injury would greatly benefit from it as well. Meditation, it is also believed, can slow down the onset of various types of dementias.

According to research, there are many benefits to doing regular meditation besides the ones mentioned above. It can also help people stay focused, can boost feelings of happiness, contentment and well-being. Mindfulness meditation is also thought to help post traumatic stress disorder (PTSD). And it is linked to metabolism, brain activation, blood pressure and stress and pain reduction. Meditation tunes out self-centered thinking and it is thought that it may re-wire the brain and provide cognitive benefits. Again this makes it especially good for those who have suffered a traumatic or acquired brain injury.

Meditation cultivates positive emotions, emotional stability, better focus and control, reduced levels of stress, mindful behavior and it bolsters the immune system. It also helps to reduce the symptoms of compulsive disorder and helps with chronic anxiety and depression.

Meditation requires deep concentration. For those who practice Mindfulness meditation, it opens their awareness to present bodily sensations, i.e.: their breathing, the beat of their heart, their thoughts and their emotions. Mindfulness meditation calms and nourishes the brain while it increases the blood flow to the brain.

The technique of Mindfulness meditation is being aware of present thoughts and actions but anchoring yourself to perhaps your breathing. This is to be aware of each breath as you breathe in and out, aware of the length of each breath and aware of your body as a whole. This will encompass feelings of a calming of your body with each breath in and out you take. If your mind wanders, bring it gently back to your breathing technique or whatever other bodily function you are focusing on.

In this fast-paced world, we all would like to reduce the stress in our lives and have serenity and calmness surrounding us. Meditation therefore, points to the many benefits, as mentioned above, as well as the importance of helping people as they age and those who have suffered brain injuries.

The Best Ways to Keep Your Brain Healthy

How can you keep your brain healthy if you have suffered a brain injury or are trying to protect your brain against the effects of aging? There are many ways you can do this.

Practicing brain health is extremely beneficial for brain injury victims and also for those who wish to delay or prevent the symptoms of aging. Making brain healthy choices plays a critical role in thinking, feeling, remembering, working, playing and sleeping. It is important to be physically active, eat a brain healthy diet, and to keep socially and mentally active. By strengthening brain cells and increasing the connections between the cells, new nerve cells may be created.

Researchers feel that those with low levels of education have a higher risk of Alzheimers later in life possibly due to a lower level of lifelong mental stimulation. That's not to say that well educated people do not get Alzheimers. They do. But symptoms may appear later in their lives than those with less education.

It is important to stay curious and commit yourself to lifelong learning by attending lectures and plays, enrolling in continuing education courses, playing games and doing memory exercises.

The brain has the ability to change and adapt following a brain injury and even into old age with the right stimulation. This is especially true for the learning and memory areas of the brain. One way of helping with memory is to chunk numbers like phone numbers, credit card numbers and license plate numbers. But other things can be remembered this way also, i.e.: a grocery list. If you have four vegetables to get, five items of meat and three breakfast requirements, remembering the number of items in each category helps to recall what they are.

Healthy relationships stimulate our brains also. Researchers are discovering that those with the most active social lives have the slowest rate of memory decline. Besides spending time with friends, volunteer, join a book club or any other kind of social gathering.

Laughter also encompasses several areas of the brain even when we are laughing at ourselves. And if you spend time with children, laughter will almost certainly be your companion because children laugh more than adults do. It is important to avoid stress where possible as it destroys brain cells. You can de-stress by doing meditation. It is believed that meditation can change the actual brain.

Brain enhancing foods are fruit, vegetables, fish and the omega-3s. A Mediterranean diet is a brain healthy diet. Also it's a good idea to decrease the amount of salt in your diet and to keep alcohol consumption at a minimum as well. Challenge your brain with brain exercises in some form on a daily basis. Add color to your life as color also stimulates the brain, as does music. It is important also to make regular visits to your doctor as some prescriptions and over-the-counter medications can fog your memory. Also conditions such as a thyroid problem can make you foggy-headed.

Other things that contribute to a healthy brain are playing video games, really listening when people are speaking, reading the news, debating, redecorating, redesigning and rearranging, and taking the B vitamins but especially Vitamin B12.

Another important thing to consider when thinking of the health of our brain is the question of whether we have a purpose in our life. Having a purpose keeps the mind youthful and active.

Memory and Keeping Your Brain Healthy

Our brains consist of five cognitive functions. They are memory, attention, language, visual-spatial skills and executive function. It is important to exercise all five areas in order to keep our brains healthy as we age and particularly if brain injury has been an issue.

Memory is one of the most important functions of our brain, and paying attention to our surroundings helps with the way our brains work. This is particularly true for someone who has experienced a brain injury. Some of the ways to assist with memory and other cognitive functions are:

- Practice remembering phone numbers instead of always referring to them in their written form.
- Make it a habit to remember conversations, and who you told what to. Repeating conversations to the same people is a sign of mental decline.
- Pay attention to the people you meet so that you will be able to remember their faces when you meet them again. Is there something unique about them? Do they have beautiful teeth, freckles or a crooked smile?
- The same applies to remembering names. Think of a way that works for you in assisting your memory. I have a good memory for names IF I really listen when I'm being introduced and repeat the name to myself immediately following each introduction. For other people associating seems to work best, i.e.: they may remind you of someone else or maybe you like rhyming.
- If your way of remembering things is more visual than auditory, be sure to write everything down, i.e.: describe a person you just met making note of their name. Writing something down helps with the memory process.
- Pay close attention to detail. A good example of this is when you park your car in a parking lot. Take particular note of where you've parked, i.e.: line up your car with something on the building you will be going into, perhaps part of the name. That way you will have no trouble finding your car again.
- We always remember things that are important to us. If we like math, we'll be good at math; if we enjoy reading, we'll in all likelihood remember what we've read because we probably don't read what doesn't interest us.
- Repetition helps our memory also. We probably remember the pizza delivery telephone number easier than the dentist because we likely phone them more often - if you do make an effort to remember numbers. When we were children and had to remember a poem, how did we do it? If you were like me, you repeated it over and over again.
- Increase your brain's capacity to remember by doing things like: learning a new word, and its meaning, every day. Learn a new telephone number each day. Attempt to learn something new that you didn't know before, i.e.: a new language, writing or memorizing poetry or new dance steps.
- Flex your mental muscles and play Scrabble, play strategic card games such as Bridge, Poker or Hearts, do crosswords or do Suduko.
- Multitasking activates different areas of the brain at the same time. So sharpen your brain and ward off Alzheimer's by reading while you're on the treadmill, sort photos while talking on the telephone or do any number of other dual functions.

Exercise is also important to the health of your brain. It makes your blood flow and allows you to concentrate and focus despite any background noises or disruptions. Why not make life more enjoyable while you are increasing the potential of your brain?

Don't Let A Stroke Get You

Strokes are an acquired brain injury affecting the brain as well as the body. (New beliefs are now that strokes also fall under the category of a traumatic brain injury.) There are things you can do to help prevent this from happening to yourself or to any of your loved one. How can you prevent it from happening?

Strokes don't just strike those in their sixties, seventies and eighties. Even those in their thirties and forties should be aware of the dangers of strokes because they are at risk also. What can you do to help prevent getting a stroke? The following steps are a good beginning:

- Are you overweight?
Eat a low fat diet. Know what is healthy and what is not. Some of the healthy foods are nuts, fish, vegetables, fruits, yogurt and whole grains. Avoid junk foods and late-night snacking. Avoid foods high in sodium and drink a lot of water. Avoid restaurant food which is always high in sodium and fat content.
- Do you have high cholesterol?
- Do you have high blood pressure?
Often these go hand-in-hand but not always. Even those who are not overweight can have high blood pressure and high cholesterol. Get cholesterol and blood pressure checked regularly.
- Do you get enough exercise?
Exercise every day and on those days where you don't feel you have enough time, do things like walking from the end of the parking lot, take the stairs instead of the elevator and do some exercises while you're watching the evening news.
- Do you have a lot of stress in your life?
A lot of our stress is the pressure we put on ourselves. Many of the things we think we have to do right now can wait, i.e.: doing the dishes, returning that phonecall, vacuuming or picking up after our family just because we've always done it. Enlist your family member's help in getting things done. Take time to relax.
- Do you smoke?
Smoking is not good for you. It restricts your blood vessels.
- Do you have diabetes?
It is important to keep this disease under control not only for general health reasons but as a prevention for strokes as well.

The statistics are not good. The incidence of stroke is expected to double in the next ten years. Also it is expected that Canadian children will be the first generation who are not likely to live longer lives than their parents. That is a sad outlook for the next generation. But with simple lifestyle changes perhaps we can prove these statistics to be wrong.

Besides making healthy changes to our lives, it is important to know the symptoms. They are as follows:

- A sudden numbness or weakness in the face, arm, leg or on one side of the body.
- Sudden confusion, trouble speaking or understanding when others are speaking.
- Sudden trouble seeing out of one or both eyes, or possibly experiencing double vision.
- Sudden difficulty in walking, feelings of dizziness or lack of coordination.
- A sudden extreme and severe headache.
- A feeling of nausea.

There is a three hour window of opportunity to successfully treat a stroke. It is imperative to call 9-1-1 immediately and get medical help as soon as possible. Getting the proper help could make the difference in avoiding a lifelong disability.

What Can You Do For Brain Injury Awareness Month?

March is Brain Injury Awareness Month. It is important that people be made aware of the dangers they put themselves in and the risks they take so that they can avoid being included in the statistics of a brain injured survivor. What can you do to help others avoid the pitfalls?

There are many ways you can do your bit to help make people aware. Brain injuries are considered a hidden disability. You can help to bring it out into the open by doing some of the following things.

Start with your workplace. Ask if you can highlight the effects and causes of traumatic brain injuries, acquired brain injuries and concussions. Help your colleagues realize that brain injury is the number one killer and dis-abler of people under the age of forty-four. The incidence is two times greater in the male population.

Make sure that your colleagues know also that these injuries will result in impaired cognitive, physical, emotional and/or behavioural functioning. The social and economic consequences can be devastating not only to the survivor but to his/her family members and caregivers as well as to the entire community.

Perhaps put a container in your office and encourage everyone to donate their change to the local Brain Injury Association. Every penny counts as there is a serious lack of funding for brain injuries.

If you are a survivor or a family member of a survivor, tell everyone you know or meet about the consequences of such an injury and the efforts they can make to avoid suffering a tragedy such as this. What are the causes? They are automobile and motorcycle accidents, sports injuries, falls, strokes, tumours and aneurysms.

The consequences can include short-term memory difficulties, motivational problems, anger issues and many other cognitive-behavioural challenges. You can lessen the chances of getting a brain injury by avoiding high risk behavior, wearing appropriate head gear, eating a healthy diet and ensuring that you are doing everything you can to look after your personal well-being by living a healthy lifestyle.

You can also encourage your state/province and municipal governments to become involved in making people aware of brain injuries. Another idea is to write letters to the editor of your local newspaper. You can ensure that the parents of the children on your son or daughter's sports teams are aware of the seriousness of concussions as well. Until recently most people downplayed concussions.

Hopefully by making people aware of the life altering results of brain injuries, everyone will think seriously before they drink and drive, speed, have their mind on other things when they are behind the wheel of a motor vehicle; will take proper precautions when they are playing sports and if they have suffered a concussion that they will take the time to rest and let the damage repair itself before returning to the sport.

It is important for people to remember that taking risks is not smart. It can be the dumbest thing you ever did. But after the fact is too late to wish you hadn't done it. Be smart now before it's too late. Remember the old saying, 'Better safe than sorry.'

Brain Injuries and Addictions

Which came first, the chicken or the egg? The same might be said about brain injuries and addictions. Are those already suffering from addictions more likely to have brain injuries? There is a theory that this may be the case.

If this is the case, where does one begin to help keep brain injuries from happening? There is evidence to indicate that substance abuse often becomes a factor following a brain injury. But there is equal evidence to indicate that some of those who have had substance abuse problems before their injuries have contributed to them by putting themselves into high risk situations.

When does it begin? Learning disabilities, behavioral problems and emotional dysfunction are some of the childhood issues that could contribute to the risk of brain injuries later in life. These children are usually not identified early enough. Teens who abuse alcohol and drugs have been discovered to have brain abnormalities which sometimes leads to cognitive impairment. This also places them at a higher risk for brain injuries. And even more serious is that a high percentage of the prison population, males in particular, have suffered a brain injury and have also had a background of teen substance abuse. According to some experts in the field, more programs are needed to address these childhood problems before they experience more serious issues by putting themselves at risk.

Following a brain injury, many sufferers, once released from the hospital may resume their previous patterns of behavior because they have more free time, fewer activities to keep them busy and they find drinking or using drugs is a way of dealing with the emotional consequences of their injury.

Even those brain injury survivors who have not previously been substance abusers may do so because of boredom and the fact that former friends may rarely visit. Tolerance for alcohol is decreased following a head injury and even small amounts can further decrease cognitive and physical functioning. Because of memory deficits, survivors are unlikely to be aware of the extent of their substance abuse or at the very least will not be willing to admit to the extent of their use. As family members, by necessity, return to work and other activities, it is difficult to monitor so it is easy for the brain injured patient to become involved in a lifestyle of substance abuse.

And because symptoms of alcohol abuse such as an unsteady gait and slurred speech can be similar to some symptoms of brain injury, it is difficult to determine whether in fact they have a problem with substance abuse. But many types of alcohol and a drug such as marijuana especially have a distinctive odor. It may be necessary also to notice whether these symptoms are only noticeable when the patient has been on his own. Unfortunatelhy, brain injury recovery is difficult, if not impossible, if alcohol or substance abuse is a factor.

It is important to know when there is a risk for brain injury to happen and to take the necessary steps toward prevention. This is particularly true in the case of children who, because of various situations in their lives, are more at risk.

Post Traumatic Stress Disorder

PTSD (Post Traumatic Stress Disorder) often follows a Traumatic Brain Injury. It is an anxiety disorder triggered by stress such as physical or sexual assault, combat or the witnessing or involvement in a traumatic event. Veterans returning home from war often experience PTSD.

This disorder is diagnosed in almost thirty percent of patients suffering from a Traumatic Brain Injury. It is important for clinicians to get as much detailed history of the injury as possible to properly determine the treatment process for PTSD. Diagnosis is sometimes difficult to determine because the symptoms of Traumatic Brain Injury and Post Traumatic Stress Disorder can overlap.

Some of the symptoms of this disorder are flashbacks, repeated upsetting memories or nightmares, emotional numbing with feelings of detachment, the tendency to block out important aspects of the trauma, lack of interest in normal activities and feelings that they have no future. They may also have difficulties with concentration, outbursts of anger, difficulties sleeping, dizziness, rapid heart beats and headaches.

Those suffering from brain injuries as well as PTSD may also have difficulties with substance abuse which can complicate recovery. Other problems may include feelings of lack of control, difficulties with positive emotions, amnesia of the event, reduced cognitive abilities, sleeping disturbances, irritability, concentration deficits and almost certainly memory challenges. Many may also have feelings of survivor's guilt. For those who had an extended period of unconsciousness following a brain injury, it is believed there is less likelihood of Post Traumatic Stress Disorder occurring. Psychological, physical, genetic and social factors are usually involved when there has been both a Traumatic Brain Injury and PTSD.

It is important to get early diagnosis. Treatments by qualified personnel to help reduce some of these symptoms include having the sufferer attempt to remember the traumatic event and express their feelings about it. Joining a support group will also be important and having a strong support system of family and friends. If depression or other related medical conditions are a factor, it will be necessary to deal with these before treatment for PTSD can be begun. It will also be important to overcome alcohol or substance abuse before any treatment can be successful.

Other treatments include talk therapy, cognitive-behavioral therapy, psychotherapy, exposure therapy and/or medication. Treatment can require from three to six months or possibly longer.

It is important for both Traumatic Brain Injury and PTSD sufferers to ensure that early diagnosis and treatment is established for the best chances of a successful recovery.