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April 17, 2014 / 17 Nisan, 5774
At a Glance

Posts Tagged ‘Brain Injury’

Struck by Lightning at Camp, Ethan Kadish Battles Brain Injury

Tuesday, August 20th, 2013

On Saturday, two weeks after Ethan Kadish’s 13th birthday, the members of his family will gather around a Torah scroll in the chapel of Cincinnati Children’s Hospital for a small ceremony marking his entrance into adulthood.

This was not the bar mitzvah that Scott and Alexia Kadish envisioned seven weeks ago when Ethan was still at the Goldman Union Camp Institute, a Reform Jewish summer camp in Zionsville, Ind.

Scott and Alexia had just finished mailing Ethan’s bar mitzvah invitations and were making final plans for a week of vacation when they received the call: While helping younger campers learn the rules of Ultimate Frisbee, Ethan and two other children had been struck by lightning.

The other children were released from the hospital soon afterward. But Ethan, who suffered cardiac arrest as a result of the strike, was in critical condition. Nearly two months later he is still fighting the effects of a catastrophic brain injury.

“We know that Ethan will be in the hospital for many months,” Scott said. “But the progress we have seen — which we are measuring week to week and month to month, not day to day — has been in a forward direction.”

Initially hospitalized in Indianapolis, Ethan was airlifted to Cincinnati Children’s Hospital in early July. After two weeks in intensive care, he has regained the ability to breathe on his own, but he remains unable to engage in purposeful movements. Although he has irregular periods of open-eyed wakefulness, his parents told JTA they are not sure of the extent of his vision.

The family has benefited from the support of their community, including their rabbi, Sissy Coran of Rockdale Temple in Cincinnati, who spent the night with the Kadishes on the second day of Ethan’s hospitalization. Meals have been delivered to them three times a week, and hundreds have signed up for Team Ethan on the Lotsa Helping Hands website, which assists families caring for a sick relative.

“We have experienced the best of humanity,” Alexia said.

Now the family is seeking another kind of help.

In cooperation with the HelpHOPELive fundraising website and the Great Lakes Catastrophic Injury Fund, the Kadishes are hoping to raise money to cover Ethan’s medical expenses, many of which will not be covered by insurance, they say.

In an interview, the couple — who also have set up a webpage to keep well-wishers informed of Ethan’s condition — were candid about the emotional difficulties of the preceding weeks, from the anguished ride from Cincinnati to the hospital in Indianapolis, to the emotional pain of having an unresponsive child. But they remain hopeful.

Recently they took Ethan outside into the sunlight and were rewarded with a response from their son: a tiny but unmistakable laugh.

Nonetheless, as they prepare for the months and years ahead, the Kadishes are cognizant of the many challenges facing their family. They have two other children, ages 16 and 10.

“Our other children certainly know there has been a huge change in our family lifestyle,” Alexia said. “They see how many hours Scott and I spend at the hospital. But we’re trying really hard to create a schedule as the school year starts to provide some source of normalcy in our family unit.”

“This,” Scott added, “is our new normal.”

Tel Aviv U Researcher Says Marijuana Can Halt Brain Damage

Friday, May 31st, 2013

Extremely low doses of marijuana’s psychoactive component can protect the brain before and after injury, according to Tel Aviv University Prof. Yosef Sarne.

Medical cannabis is often used by sufferers of chronic ailments, including cancer and post-traumatic stress disorder, to combat pain, insomnia, lack of appetite, and other symptoms but has not been  identified as being able to prevent damage to the body.

Prof. Sarne of the Adelson Center for the Biology of Addictive Diseases says that the drug has neuroprotective qualities and that extremely low doses of THC –  the psychoactive component of marijuana – protects the brain from long-term cognitive damage in the wake of injury from lack of oxygen, seizures, or toxic drugs. Brain damage can have consequences ranging from mild cognitive deficits to severe neurological damage.

Previous studies focused on injecting high doses of THC within a very short time frame of approximately 30 minutes  before or after injury. Prof. Sarne’s current research, published in the journals Behavioural Brain Research and Experimental Brain Research, demonstrates that even extremely low doses of THC around 1,000 to 10,000 times less than that in a conventional marijuana cigarette and administered over a wide window of up to seven days before or one to three days after injury can jumpstart biochemical processes which protect brain cells and preserve cognitive function over time.

This treatment, especially in light of the long time frame for administration and the low dosage, could be applicable to many cases of brain injury and be safer over time, Prof. Sarne says.

In the lab, the researchers injected mice with a single low dose of THC either before or after exposing them to brain trauma. A control group of mice sustained brain injury but did not receive the THC treatment. When the mice were examined three to seven weeks after initial injury, recipients of the THC treatment performed better in behavioral tests measuring learning and memory. Additionally, biochemical studies showed heightened amounts of neuroprotective chemicals in the treatment group compared to the control group.

The use of THC can prevent long-term cognitive damage that results from brain injury, the researchers conclude. One explanation for this effect is pre- and post-conditioning, whereby the drug causes minute damage to the brain to build resistance and trigger protective measures in the face of much more severe injury, explains Prof. Sarne. The low dosage of THC is crucial to initiating this process without causing too much initial damage.

According to Prof. Sarne, there are several practical benefits to this treatment plan.

Due to the long therapeutic time window, this treatment can be used not only to treat injury after the fact, but also to prevent injury that might occur in the future.

For example, cardiopulmonary heart-lung machines used in open heart surgery carry the risk of interrupting the blood supply to the brain, and the drug can be delivered beforehand as a preventive measure. In addition, the low dosage makes it safe for regular use in patients at constant risk of brain injury, such as epileptics or people at a high risk of heart attack.

Prof. Sarne is now working in collaboration with Prof. Edith Hochhauser of the Rabin Medical Center to test the ability of low doses of THC to prevent damage to the heart.

Preliminary results indicate that they will find the same protective phenomenon in relation to cardiac ischemia, in which the heart muscle receives insufficient blood flow.

The Long Road of Stroke Recovery

Thursday, May 31st, 2012

What does an elected official in his fifties have in common with a young Chassidic father, a young mother who works as a freelance copy editor, and a 21-month old infant? All four individuals, from very different backgrounds and walks of life, suffered a stroke which robbed them of some of their previous abilities, and prompted an individualized recovery process which is likely to last for the rest of their lives.

Of the four, only New York State Assemblyman Steven Cymbrowitz, representing the 45th Assembly District in Brooklyn, experienced the classic symptoms that we usually associate with a stroke, a sudden interruption of normal blood flow to a portion of his brain as the result of a blood clot, which nearly took his life one morning in March, 2005. They are all part of a fellowship of more than 500,000 people in the United States each year who suffer a stroke or traumatic brain injury (TBI), leaving one-third of them with a permanent disability.

Strokes are the third leading cause of death in the U.S. They are usually associated with middle aged or elderly individuals, but they can befall individuals at any age, even young children. According to Chavie Glustein, the founder and director of BINA, a Brooklyn-based organization providing a broad range of services to hundreds of families dealing with the aftermath of stroke and brain injury, in discussions of treatment and recovery, TBI is often included with stroke, because its impact on the patient is often virtually identical to that of a stroke. TBI can result from common events such as falls, vehicular accidents, and sports injuries, to name a few, and is a leading cause of death and disability in children and young adults.

While the severity and effects of stroke and TBI vary widely, medical science has developed an effectively arsenal of medical equipment, medications and therapies to treat victims of both conditions, and to assist in their recovery. Those who survive often require years of therapy and rehabilitation, and even those who successfully recover will still have to deal with the effects years after resuming their normal day-to-day activities.

Lifesaving Decisions

Assemblyman Cymbrowitz credits his wife Vilma for saving his life by telling the ambulance driver who responded to her 911 call to take him directly to the Stroke Center of Maimonides Hospital in Brooklyn. There a team of specialists used the MERCI (Mechanical Embolus Retrieval in Cerebral Ischemia) Retriever to remove the blood clot which was blocking one of his cerebral arteries.

Cymbrowitz survived because he received aggressive treatment within the critical initial 180 minute period from the onset of symptoms, what doctors call the “golden hour.” The prompt treatment also limited the damage the stroke did to his brain, and enabled him to recover very quickly. He returned to Albany to resume his official duties just two weeks after suffering the stroke, but today, seven years later, he is still dealing with its more lasting effects.

Younger Victims

A. is a 5-year-old girl who suffered extensive brain damage from a stroke at the age of just 21-months. Her doctors still do not understand what triggered the stroke, but the effects of her cerebral infarction (the death of brain tissue due to the interruption of the blood supply), were devastating.

A. had experienced some earlier developmental delays, but just before she suffered her stroke, seemed to be catching up. She was babbling happily and on the verge of starting to walk, when the stroke came on without warning. In a coma and barely breathing, A. was rushed to the hospital by her frantic parents.

When she came out of the coma, it was soon clear that she had suffered a major setback to both her physical and cognitive development. She could no longer stand or even crawl. She was subject to seizures, and lost her ability to babble.

Medication stopped the seizures and thanks to intensive physical and occupational therapy, A. can now walk and even run. But she is still at a cognitive development level of about 12-18 months. She has virtually no ability to communicate, and her progress in speech therapy is painfully slow.

A. now attends a special needs school not far from her home in Great Neck, Long Island. Her parents are grateful for the support they have received from their community and groups like BINA, which provided them with encouragement and the latest information on the wide range of treatments and resources available for their daughter and other stroke and TBI victims.

Causes and Effects

The survival rate for stroke and TBI has been significantly improved by the establishment of stroke centers like the one at Maimonides, equipped with the latest imaging equipment, medications and treatment devices, and a specialized staff experienced in their effective use. A significant advance is the introduction of computer-controlled robotic devices such as the Lokomat (depicted on the cover) at leading rehabilitation and stroke recovery centers around the world. Lokomat provides patients who cannot stand or walk on their own with physical support against the pull of gravity and motorized assistance for their limbs and muscles. It also has a computer monitor which uses video game-type simulations to give the patient instant positive or negative feedback on their movements on the treadmill. The result is more productive therapy sessions, speeding up the recovery process.

Printed from: http://www.jewishpress.com/sections/health/the-long-road-of-stroke-recovery/2012/05/31/

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