Friday, March 22, 2013

Raising awareness of traumatic brain injury

A team effort: From left, Edlow, Hirschberg, Guller and Kearney

ONE MOMENT TOM KEARNEY was walking along busy Oxford Street in London, England – the next he was laying on the pavement with a cracked skull, collapsed lungs and blood streaming from his ears and mouth. It was Dec. 18, 2009, and the businessman and Harvard University graduate had just been struck by a 16-ton bus – the impact projecting him 20 feet down the street and leaving him in a near-death coma.

Kearney is one of an estimated 1.7 million people throughout the world diagnosed annually with a traumatic brain injury (TBI). While many are mild forms, such as concussions, others, like Kearney’s, are much more severe. Kearney spent two weeks in the coma as doctors treated his extensive head and chest injuries before embarking on a nearly two-year road to recovery – a journey he shared during the March 12 “Traumatic Brain Injury Awareness Scientific Symposium” in the O’Keeffe Auditorium.

Hosted by the MGH Neuroscience Intensive Care Unit and the Maxwell and Eleanor Blum Patient and Family Learning Center, the event was held in recognition of Brain Injury Awareness Month. Other events included a poster session, information table in the White Lobby and a scientific panel discussion which featured insights from Ronald Hirschberg, MD, physiatrist at the MGH and Spaulding Rehabilitation Hospital; Brian Edlow, MD, a neurocritical care fellow; and Yelena Guller, PhD, a neuropsychology fellow at Spaulding Rehabilitation Hospital.

“Recovery from TBI is something that we are only just beginning to understand,” said Jonathan Rosand, MD, MSc, medical director of the Neuroscience Intensive Care Unit and chief of Neurocritical Care and Emergency Neurology. “But it is clear that recovery from TBI is a team effort.”

The key to advancing the care of patients with TBI is multifaceted, but two main components are in-depth research and creating a systematic approach and assessment during the rehabilitation process. “Every patient is built uniquely, but a structured and a standardized approach is key as we move forward in studying TBI,” said Hirschberg. “Awareness is also extremely important. This is really a neglected community of people who don’t have the resources that they should.”

Edlow provided an overview of the extensive MGH research studies now underway, including his efforts to advance neuroimaging techniques to help explain why and how patients regain consciousness following a TBI. Edlow said his efforts also are focused on a new Center for Integration of Medicine and Innovative Technology grant for a Traumatic Coma Response Study, which will test whether advanced imaging biomarkers can help predict this recovery of consciousness in patients admitted to the MGH with traumatic coma.

“This will enable us to better understand the pathology and enable us to better treat patients with TBI in the future,” Edlow said. “Through several national consortia, MGH and Spaulding are partnering with other leading academic centers around the country to understand the biological mechanisms underlying recovery from TBI and exploit those mechanisms to develop successful interventions for TBI survivors from all over the world.”

Read more articles from the 03/22/13 Hotline issue.

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