Traumatic brain injury patients must adapt to a new reality

We're talking about, reviewing, and updating several articles we had written just a few years ago about traumatic brain injury. We had received so many comments and questions about TBI, we thought that it might be appropriate to provide additional information about it, along with a more current update on its symptoms and treatments.

Last week, we reviewed the causes of TBI and what their symptoms might be.This week, we'll discuss the disabilities and treatments that people coping with a TBI may have to deal with depending on their severity.

Approximately half of severely head-injured patients will need surgery to remove or repair hematomas (ruptured blood vessels) or contusions (bruised brain tissue) resulting from their TBI. Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury and the age and general health of the individual. Some common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

More serious head injuries may result in stupor, an unresponsive state, but one in which an individual can be aroused briefly by a strong stimulus, such as sharp pain; coma, a state in which an individual is totally unconscious, unresponsive, unaware and unarousable; vegetative state, in which an individual is unconscious and unaware of his or her surroundings, but continues to have a sleep-wake cycle and periods of alertness; and a persistent vegetative state, in which an individual stays in a vegetative state for more than a month.

The National Institute of Neurological Disorders and Stroke conducts TBI research in its laboratories at the National Institutes of Health and also supports TBI research through grants to major medical institutions across the country. This research involves studies in the laboratory and in clinical settings to better understand TBI and the biological mechanisms underlying damage to the brain.

This research will allow scientists to develop strategies and interventions to limit the primary and secondary brain damage that occurs within days of a head trauma, and to devise therapies to treat brain injury and improve long-term recovery of function.Unfortunately, the cells in the central nervous system, including the brain, do not regenerate or heal themselves such as a broken bone or a significant cut on one's arm would.

This is one area where stem cells, once we can get by the politics, may hold great promise in possibly curing such physical difficulties as TBI, spinal cord injuries, Alzheimer's and even blindness and stroke disabilities, to name just a few of those CNS problems where stem cells might possibly hold the key for CNS cell regeneration.

In the meantime, though, we have to deal with what the reality is.That reality says:Prevention is the best way to ensure that we don't incur TBIs, SCIs and strokes upon ourselves; that, if we do, then we have to exhaust every possibility of effecting as much recovery as possible; and that, once there seems to be no other real possibility of further recovery,we work as hard as we can to find those ways that will help us to cope and live with whatever disability we now have, especially those of us who are trying to deal with a TBI.

At the same time, it certainly wouldn't hurt to begin and maintain a conversation with our elected officials to try and convince them to get the use of stem cells out of the political arena and into the scientific and medical arena where they belong.Fetal stem cells are not the only type of stem cell that can be used to effect such cell and/or organ regenerations.A number of nonfetal stem cell lines have already been identified as holding the promise of "curing" such physical difficulties, while others are being developed as we speak in other countries.Think about it.