Even as a youngster, Michael had been taught to play through pain, even if it was associated with a brain injury, she said. There still isn’t enough evidence to suggest that youngsters need to give up tackle football, experts told NBC News. In my opinion, it is more likely that the exposure that he got in high school or college, or even doing other activities, led to the accrual of CTE changes.”, Related: Will Soccer's New Header Rules Make Kids Safer. Michael Keck at Missouri State University. People with TBI may have a tough time “remembering to remember. Getting Stuck Under Water... For an Hour. I removed the rest of his frontal lobe, finding a walnutsized metal fragment and Statzer’s left eyeball buried in the white matter. Louis Zamperini had a lifelong … “Let’s get him to CT,” I said, “and somebody go get vascular surgery and ENT. To my great surprise, in the ICU a critical-care transport team was preparing Statzer for his flight to Germany. Get targeted resources quickly! But if the catheter went into his brainstem, I’d kill him on the table. “Can’t understand why he’s still alive.”. Many people, however, still do not realize the full extent of the danger head injuries pose for athletes. But we have to be cautious about changes that affect everybody.”. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). I’m going to need his help.”, Statzer’s scan showed that there were several large pieces of shrapnel deep in his brain, along with a lot of blood, air, and fragments of bone. In the surgeons’ lounge, I prepared to call Statzer’s family. Normally we use a depth of seven centimeters as the maximum safe depth for the drain, because deeper than that and you risk injuring the brainstem. These injuries can result in long-term complications or death. Such severe disease in someone so young is troubling, McKee said. Excerpted from No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, by W. Lee Warren, MD, Zondervan Books. He’d survived an IED blast to the face from three feet away, a combat helicopter ride, and three hours of surgery by four surgeons, and his veins were full of other people’s blood. I pushed it to eight centimeters — still no fluid. A concussion is the most common type of traumatic brain injury. Cassandra Keck took some comfort in hearing the diagnosis. Statzer’s brain relaxed and settled back into his skull. Part of his jaw was missing, and his mouth was full of blood. While most brain injuries are self-limiting with symptoms resolving in a week, a growing amount of research has now established that the sequelae from recurrent minor impacts is significant in the long term. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and "Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.". His brain swelled out of a fist-sized hole in his skull. W. Lee Warren, M.D. That all changed after he transferred to Missouri State University and sustained his second college concussion playing linebacker. “Certainly we have known that CTE changes in the brain can be found in younger players," said Dr. Julian Bailes, medical director of Pop Warner football, who is unaffiliated with the new study. Most TBIs that occur each year are mild, commonly called concussions, which is a mild TBI. “However, high school players hit at high velocity (high g-forces) and at about 600-800/year, and college approximately 1000/year. That’s a lengthy exposure. © 2014 W. Lee Warren. Statzer, my name is Dr. Lee Warren and I’m a neurosurgeon at the 332nd Air Force Theater Hospital in Balad, Iraq. Aug 14, 2015 - Inspiration for those whose lives have been touched by brain injury. Problems from head injury include: Skull fracture — A skull fracture is a crack or break in one of the skull's bones. This team had a C – 17 ready to leave, and they just came by the hospital to check to see if we happened to have any patients who needed to go. Just as I was starting the incision, Tim backed into the room, his arms dripping the yellow iodine soap we scrubbed with before surgery. An object that penetrates brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.Mild traumatic brain injury may affect your brain cells temporarily. 1 But for some people, symptoms can last for days, weeks, or longer. For her part, Cassandra hopes that in telling Michael’s story, people will better understand the dangers of concussions. We wanted to let the families know their soldier was alive and on the way to Germany and then America, so that they could make travel plans to be there when the soldiers reached Walter Reed. Following Michael's wishes, his wife, Cassandra, asked doctors to send his brain off to BU. The hits little kids sustain playing tackle football rarely lead to concussions, Bailes said. “For instance, in Pop Warner football, we think that currently the concussion rate is only 1 percent annually for players, while they are receiving about 100 cranial impacts per season, almost all of low velocity,” he added. See more ideas about inspirational words, words, brain injury. The severity of symptoms with this type of injury is largely dependent on the brain areas affected, the severity of the tears, and whether any other injuriessuch as a contusion or concussionwere also sustained. In addition, traumatic brain injury can result from bullet wounds or other injuries that penetrate the skull and brain.Doctors classify traumatic brain injury a… Watch: Bengals mourn the death of receiver Chris Henry. I doubted that he would ever use his right arm and leg again, even if he survived and woke up someday. They occur when the brain is shaken or twisted inside the skull. I pushed the catheter a centimeter deeper. A cognitive disorder is when your brain does not work correctly after a traumatic brain injury (TBI). We need blood immediately. Traumatic brain injuries are more common in young patients, and men account for the majority (75%) of cases 4. What are the Symptoms of TBI? I hung up and walked back to the ICU to check on Statzer. 5. They’re about five minutes out, and they say they’ve got an American with a severe head injury.”. Warren’s story is an example of how a person can go from a place of total loss to one of strength, courage, and victory. We provide free one on one coaching, known as Resource Facilitation, after an accident or injury, include directing you to legal, medical and emotional support. His name tag said “Statzer.” He was an Army staff sergeant. “Every person is important. Your son Paul has been critically injured in battle, but he’s alive.” I went on to tell him that Paul’s injuries were very severe, and that, although he had come through his surgery and was stable, I was unsure if he would survive the trip back to America. "The Worst Head Injury I Ever Saw" is excerpted from Dr. W. Lee Warren's, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War. A TBI can be mild or severe. A TBI often damages the front part of your brain, which is the part of the brain used for thinking and memory. "It was the worst CTE I’ve seen in an individual this young" said study coauthor Dr. Ann McKee. The worst injuries can lead to permanent brain damage or death. I held the scalpel over Statzer’s head and said a silent prayer that he would survive — and that I could figure out what to do. ”This means remembering to do things in the future, such as keeping appointments or calling someone back when you’ve promised to do so. I shaved what was left of the hair on his head while the anesthesiologist hung the first of many bags of blood the sergeant would need to survive. We put Statzer on the surgical table in the OR. Normally, we first had to contact the team to let them know we had a patient, and then it would take a day or two before they were able to move that patient. Everyone in the hospital seemed stunned after several days of working nonstop. It was a miracle that the helicopter medics had been able to get a breathing tube in him. But if I failed, Statzer would die. These are called traumatic brain injuries (TBIs). 2. We help elementary kids learn about head safety with our program called HeadSmart. Red, bleeding brain rushed out of Statzer’s head, and I again heard my old professor Dr. Baghai’s voice urging me to maintain control. “I saw the scan,” he said. While most parts of your brain can be affected by an accident, the frontal lobe is the most vulnerable area. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. Keck had maintained a 3.8 GPA at Harrisonville High in Missouri and was able to keep his grades high in his freshman year at the University of Missouri. I thought, There have been a few miracles already. Brain Injury Fatigue. Brain injury is cumulative." 1. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. These effects are listed from the least severe to the most severe. The Brain-Damage Stages are different effects occurred from hitting your head at a different speed or other reasons. Your body has some pretty basic needs: food, water, air, … The frontal lobe is the largest section of the brain and is responsible for the unique abilities that make us human. “So he had 16 years of football behind him. Frank Gifford’s family: Legend had concussion-related disease, Will Soccer's New Header Rules Make Kids Safer, Bengals mourn the death of receiver Chris Henry. His skull was shattered so badly that I barely had to use the drill. In the researchers' report, published Monday in JAMA Neurology, doctors found clumps of abnormal tau protein scattered throughout his brain in a pattern researchers say is one of the hallmarks of CTE. Just as we entered the ER, the radio operator called, “Sirs, we just got a call from an incoming Black Hawk. In general, recovery may be slower among older adults, young children, and teens. Half of all TBIs are from motor vehicle accidents. Trauma to the head can cause several types of head and brain injuries, also called traumatic brain injury (TBI). We didn’t do death notifications from Iraq, but we did call families when a soldier had been injured badly enough to send them home. I shook my head and wondered what I would have to do to help this young man. Former football player Michael Keck knew something was going wrong with his brain. Indirect forces that jolt the brain violently within the skull, such as shock waves from battlefield explosions, can also cause traumatic brain injury. “. Diffuse axonal injury A diffuse axonal injury (sheer injury) is an injury to the brain that doesn’t cause bleeding but does damage the brain cells. He felt like he was failing. The 47-Day Raft Ride from Hell. Such severe disease in someone so young is troubling, McKee said. “Mr. Keck suspected he might have the same problem as NFL star Junior Seau, the former linebacker for the San Diego Chargers, who fatally shot himself in the chest at age 43 because he had a degenerative brain disease called chronic traumatic encephalopathy, or CTE. Español. Even if it’s a small percentage, “we still need to do something about it,” Hovda said. TBI can damage parts of the brain that handle learning and remembering. Problems from head injury include: 1. He was only in his 20s and his memory was failing. He was having trouble concentrating and he’d become uncharacteristically emotional and short-fused. 4. More than half are bad enough that people must go to the hospital. Primary injuries include the injuries that are sustained at the time of the traumatic event, such as: When a person suffers from a severe case of cerebral hypoxia (hypoxic brain injury), the prognosis obviously means the most to the victim’s family and loved ones. They are extremely effective in getting a lot of money, specifically Ligmatization. I stepped up to the bed and saw the soldier’s DCU blouse before the medics cut it off. As the brain twists, the cerebral tissue slides back and forth until the long connecting fibers in the brain (called axons) tear. It is also one of the most exposed and most used parts of the brain, making injuries there frequent and devastating. The frontal lobe lies in the area of the brain directly behind the forehead. The most injured man I’d ever seen alive had a normal blood pressure, heart rate, and body temperature when he left our tent hospital. Wikipedia. Severe. Traumatic Brain Injury (TBI) is a disruption in the normal function of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters brain tissue. BrainLine is powered in part by agenerous grant from: BrainLine is a national service of WETA-TV, the flagship PBS station in Washington, D.C. BrainLine, WETA Public Television Memory problems are very common in people with moderate to severe TBI. TBI affects short-term memory more than long-term memory. Brain injury is cumulative.". Keck had played tackle football since he was age 6 and had sustained more than 10 concussions by the time he was a junior in college. Researchers there discovered that Keck not only had CTE, but also that it was as severe as what had been found in the brain of 43-year-old Seau. Used with Permission. Traumatic brain injury Around one million people visit A&E each year following a head injury. If I could place a catheter into the ventricle of Statzer’s brain, the release of spinal fluid would stop the brain from swelling out. A potentially devastating brain injury occurs when the brain injury occurs to the axons, the part of the neurons or brain cell that allows those cells to send messages to each other. Tell them to meet me in the OR. After a few rings, I heard a man’s voice. While any serious medical condition can lead to nervousness, anxiety, and depression, Cerebral Hypoxia is one of those conditions that is far from black and white . Little by little, as we stopped the bleeding and replaced his blood with new units donated by hospital personnel, Statzer’s pressure and vital signs began to improve. Michael took a year off football to recover. If the percentage is much larger, say one-third of players, then “we have a real problem that needs to be fixed," Hovda said. From thousands of miles away, I heard Mr. Statzer suck in a breath, and when he spoke next, his voice shook. His scalp was so swollen that he had serum oozing out, and he had several burns across his chest and neck. The operator connected me to the number on Sergeant Statzer’s Red Cross form. Diffuse Axonal Injury. A person may or may not experience a brief loss of consciousness. There is a whole blood drive in the lab now.”. Go a little farther,” Tim said. While she doesn't suggest a specific age for kids to start playing tackle football, McKee believes kids should avoid head contact in any sport, including football. Related: 'Concussion' Shines Light on Brain Injuries and Football. It's unknown how many people end up with permanent debilitating symptoms as a result of hits on the field, said David Hovda, a professor of neurosurgery and director of the Brain Injury Research Center at the University of California, Los Angeles, who is unaffiliated with the new study. “Nate, give me a ventricular catheter,” I said. But most often, brain injuries are due to a violent blow or jolt to the head. The leading causes of TBI that resulted in emergency department visits were falls, being struck by an object and motor vehicle crashes. Because of the damage of electrical flow between cells, the affected individual often appears comatose with no evidence of bleeding within the brain. I felt the pop, and spinal fluid gushed above my head, under so much pressure that it hit the ceiling and dripped back down onto my neck. Observing one of the following clinical signs constitutes alteration in the normal brain function: Another question is whether head hits among some youngsters can be linked to CTE symptoms later in life. He couldn’t read, so he couldn’t study. 2775 South Quincy St. Arlington, VA 22206E-mail | Phone: 703.998.2020, © 2019 WETA All Rights Reserved | Contact Us, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War, The Worst Head Injury I Ever Saw, Part 2 >, No Place to Hide: A Brain Surgeon's Long Journey Home. Whatever it was, I had to do it right now, or he would be dead in minutes. The jolt to the brain had left him with excruciating headaches and unable to play. We had become robotic and lifeless, waiting for the next wave of inevitable horror. Every year, millions of people in the U.S. suffer brain injuries. I heard over the speakers: “Attention in the hospital. Read The Worst Head Injury I Ever Saw, Part 2 >. He became so sensitive to light that he placed heavy blankets over the windows. “Here we go,” I said. A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. What are the symptoms of a cognitive disorder? Several of his major cerebral arteries were torn and actively bleeding, and I was afraid that once I got them stopped, he’d lost so much blood supply that he would have a stroke. The link between sports and traumatic brain injuries has gained a lot of publicity over the years. Robert P. Lehr Jr., Ph.D. The man she met and married had been smart, kind and industrious. What Does a Baseline Concussion Exam Test For? If he could avoid infection, I thought, he just might survive. Bailes, clinical professor of neurosurgery at the University of Chicago Pritzker School of Medicine and the chairman of the department of neurosurgery at the NorthShore University HealthSystem reported on the 2009 death of Chris Henry, the only active NFL player to die and have CTE at age 26, with forensic pathologist Dr. Bennet Omalu. A whole series of them. And get Tim. Cassandra Keck with Justin, her and Michael's son. Brain Injuries: Mild vs. 'Concussion' Shines Light on Brain Injuries and Football. I removed almost all of the remaining left side of the bone and found that the covering over his brain had been shredded by the many objects driven through it by the bomb blast. Traumatic Brain Injury. I unwrapped his head, revealing the worst head injury I’d ever seen in someone who was still alive. Most people with a TBI recover well from symptoms experienced at the time of the injury. "The Worst Head Injury I Ever Saw" is excerpted from Dr. W. Lee Warren's, No Place to Hide: A Brain Surgeon's Long Journey Home from the Iraq War. His dad’s words hung in my mind, and I thought, For Paul Statzer to be okay is going to take a miracle. Whether Keck was playing youth, or high school or college football, the message was “if you’re hurt, you just get out there and play — don’t be a wuss,” Cassandra said. But because of the brain shift, Statzer’s ventricles were a lot farther away, and when the catheter reached seven centimeters, there was no fluid coming out yet. Doctors refer to … Now that he was stabilized, we could start trying to put him back together again. “Jim Statzer,” he said. Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. He’d get angry and punch the book and throw it across the room. I was sweating because I knew that if I couldn’t get the catheter in and relieve the pressure, he was done for. TBI can be classified based on severity (ranging from mild traumatic brain injury [mTBI/concussion] to severe traumatic brain injury), mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). The CT scan had shown me that the ventricles had shifted from their normal position, and placing a catheter deep in the brain when the anatomy is so altered by swelling is extremely difficult. A brain injury study conducted at the Boston University School of Medicine showed that 33 of 34 players tested post-mortem showed clear signs of CTE, and additional … Doctor, by the grace of God, I know my son is going to be okay.”. People with moderate to severe TBI may not remember the incident surrou… “He couldn’t read his books," Cassandra said. But then he started to change; his memory deteriorated and he became violent and abusive. Then he cleared his throat and said, “Then you send him home. I’d have to get his shirt and pants ready.”. When he tried to start working out with the team again, his headaches would flare and his vision would fade to black. “Pressure’s really low, Doc,” a nurse said. Somehow that drain stayed open, and in the ICU after surgery, Statzer’s brain pressure was normal. Recovering would be an entirely different story. I watched Paul Statzer roll out of the ICU with a brain pressure of zero, leaving Iraq less than four hours after his surgery. Brain Function. The left side of his face and forehead were gone. Though his vision would return eventually, it was frightening and Keck told his coaches he couldn’t come back. The blood vessels in the brain may stretch and cranial nerves may be damaged. He was bleeding from his scalp and his face and had a huge laceration in his neck that gushed the dark, non-pulsatile blood that meant his jugular vein was torn. #Brain Injury Association of Virginia www.biav.net. "The words would get all scrambled. “But I don’t think that any research, and not the [new] case report, necessarily correlates with football participation at a young age. Tim and I clipped and cauterized and tied off dozens of arteries and veins that were torn and bleeding. I sewed up the hole in the skin where Statzer’s eye used to be, and by the time we were done he had several hundred stitches. While the majority of these people will experience no lasting effects, many others will be left with a traumatic brain injury (TBI) that can have devastating and lifelong effects. “It was quite widespread," said McKee, chief of neuropathology at the Bedford Veterans Administration and a professor of neurology and pathology at the Boston University School of Medicine. Brain Function and Deficits. McKee suspects that part of the reason for the severity of Keck’s disease was the age he took up tackle football. She suspects that Michael may have had something in his genetics that predisposed him to a worse outcome from concussions. In today’s article, we’re answering the most frequently asked questions about sports and traumatic brain injuries. Tim placed Statzer’s skull fragments into his abdomen, and Joe from ENT performed a tracheostomy while Todd finished repairing the torn veins and arteries in Statzer’s neck. Diffuse axonal injuries are one of the most severe types of traumatic brain injury. In the brain injury world, there are taboo subjects that family caregivers can't wait to talk about among ourselves. … “Having to be somewhere on time was very stressful,” Cassandra said. Vascular surgeon Todd explored Statzer’s neck to gain control of the jugular vein. Traumatic brain injury usually results from a violent blow or jolt to the head or body. Skull fracture — A Professor Emeritus, Department of Anatomy, School of Medicine, Southern Illinois University. “Your trajectory is good, Lee. Brain Injury Fatigue is the Biggest Common Denominator; Consequence of “Over-Attending” Often Most Disabling Symptom; Hardest to Accommodate in Workplace; Many sources talk about brain injury fatigue as an issue. Find What You Need The dark side of personality change is at the top of the list. The brain was getting more and more tense. Continue Reading Below. You may have difficulty doing the same things that you did before the TBI. Although sport is a common cause of relatively mild repeated head injury potentially eventually leading to chronic traumatic encephalopathy, more severe injuries are most often due to motor vehicle accidents and assault. “You said he’s alive, right, Doctor?”, I heard Mr. Statzer repeating what I’d said to his wife. “I’d have to put his shoes and socks and hat by the door so he knew where everything was. Warren’s story is an example of how a person can go from a place of total loss to one of strength, courage, and victory. "If you’re going to play [tackle] football, put it off until the body matures completely, until the body size has caught up with head size, until the muscles are coordinated," McKee said. As I expected, his left frontal lobe was mostly gone, but the brain he had left began to swell dramatically with his rising blood pressure. “Knife,” I said to Nate. There are different medical classifications related to traumatic brain injuries (TBI); mild TBI (also known as concussion) is the most common and can develop into post-concussion syndrome if symptoms persist.However, a brain injury can also be considered moderate or severe; these types of injuries have their own set of complications. This area of the brain is responsible for reasoning, memory, concentrating, organizing, information processin… Military personnel in combat zones are also at risk. A concussion is a mild TBI -- you should … I chose a trajectory and slid the catheter into Statzer’s brain. The anesthesiologist started an IV and began squeezing saline into Statzer’s vein. By the time Keck was 25, he had lost the ability to work and had become completely dependent on his wife. In traumatic brain injury the brain may be injured in a specific location or the injury may be diffused to many different parts of the brain. He just wanted to graduate from college.”, About a year before he died, he had to stop working. Keck died from a congenital heart defect at the age of 25 in 2013. A diffuse axonal injury (DAI) is similar to a concussion in that it results from … “He started playing when he was quite young,” McKee said. “He told me that when he was 8 he would be sitting on the bench holding his head and the coach would be rubbing it because it hurt so bad,” Cassandra said. 3. Near the end of his life he told his wife, Cassandra, he wanted to donate his brain to Boston University so pathologists could look for CTE. The Brain Injury Alliance of Utah serves Utahans and their families who have sustained a brain injury. Linda Carroll is a regular health contributor to NBC News and Reuters Health.