Traumatic Brain Injuries 12/7/2015

By Katerina Biancardi

It was a feeling like walking underwater. Then, after a while, the paranoia set in.

That’s is how 19 year old Adam Roossien says he felt after suffering a traumatic brain injury.

“It’s not until when you have things taken away, you realize how fragile and special life is,”Roossien said.

Roossien is among the 2.5 million Americans who sustain traumatic brain injuries each year, according to the US Department of Health and Human Services.

In October 2014 the United States Department of Defense awarded $17 million grant to 11 public and private institutions, including the University of Texas at Austin, all in an effort to support traumatic brain injury research.

The Centers for Disease Control and Prevention National Center for Injury Prevention and Control defines Traumatic Brain Injuries as “a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain,” that range from mild to severe.

At UT Austin, Professor of Psychology, David Schnyer, says researchers have an inadequate understanding on how the brain recovers and what the true severity of any given TBI, “for example in mild cases, they can never get back to normal, and we don’t see why that is, while there are some with severe TBI that do recover.”

Each year 75 percent of the TBI are diagnosed as mild or a concussion, reports the US Department of Health and Human Services, and over the past decade the percent of children age 19 or young has risen by 57 percent according to the CDC.

Roossien received his sixth concussion in the spring of 2012 as a junior in high school.

“I dreamt of playing college lacrosse. It was the center of my life. It’s where I spend all my time and energy,”Roossien said. “But that after the sixth concussion I was done.”

Nurse Cydni Hale works specifically with concussion patients at Carolina Neurosurgery & Spine Associates in Charlotte, North Carolina.

Hale said when a concussion patient comes in she conducts a symptom survey. She explains the main symptoms associated with a mild TBI includes: nausea, vomiting, balance, dizziness, sleep, light and noise sensitivity, extreme emotions, irritability, difficulty with memory and concentration, and vision problems.

“If you do not FEEL right, you must not BE right,” Hale said. “I think honestly the biggest red flag of a concussion is a headache, but not everyone has them.”

“The best way to determine is to simply get checked if you have been hit in the head,” Hale said.

After seeing his neurologist from the sixth concession, Adams said for one month he was not allowed to: attend school, leave his house, have access to his cell phone or TV, or engage in extend conservations.

“The lights were all off in my room and quiet music was the only thing allowed,” Roossien said.

The first week feels like a complete daze, according to Roossien.

“But, after the first week you start to go stir crazy,” said Roosien.

Roosien said during the month of being home he spent his time learning how to play the guitar.

“It was a form of therapy for me. Now when I get a headache, I still play the guitar,” Roossien said.

Hale said PT, occupational therapy, vision therapy, massage therapy, chiropractic, speech therapy, neuro-psych testing, psychology are types therapy and treatment available depending on the individuals patient’s needs.

Unfortunately there is not one treatment for TBI to be proven effective for all patients, reported by the University of San Francisco.

The research study originally started in October 2013 when the National Health Institute awarded $18.8 million to several institutions. Psychology professors Alex Valadka and David Schnyer at UT Austin, were among the first group of researchers to look deeper into TBI.

However, over a course of a year, another grant was awarded due to lacking efficiency in various elements in the research process as stated by the University of California at San Francisco.

The University of California at San Francisco also reports that the new research initiative is named TBI Endpoints Development, informally know as TED, has brought “leading academic clinician-scientists with innovative industry leaders in biotechnology and imaging technology, with patient advocacy organizations, and with philanthropies.”

Chief, Dr. Geoffrey Manley of the study resides with his team. TED aims to improve clinical run studies, with the hopes of finding a treatment for TBIs through the collection the MRI imaging, genetic, and neuropsychological data.

Dr. Schnyer described the research process as “rewinding back to when we didn’t understand the different types of cancer, we are trying to do the same; to be able to differentiate the different types of traumatic brain injuries.”

Hale has seen extreme variance among her concussion patients.

“I have seen some improve to where they have no symptoms at all and fully recovered and then some who have a lifetime of seizures, need an assistive dog to make sure they are ok, and some who cannot drive or work,” Hale said.

“With a broken arm or foot, there’s a protocol of recovery,”said. “Not knowing if and when I was going to get better was the hardest.”

“And if I ever got better would I ever truly know,”Roossien said. “The recovery is not quantifiable.”

Once Roossien returned back to school he says that he felt like a different person.

“I used to be outgoing and an extrovert, but I found myself sitting with my friends, just watching and taking it all in, and unsure who I was or what was going on.” he said.

Roossien said before the injury, he used to spatial thinker and glance at his notes once and understand the material. In order to be successful in school, he had to change the way he learned, according to Roossien.

The CDC estimates that 5.3 million Americans live with TBI caused disabilities.

“I had to become a verbal thinker,”Roossien said. “Then and now, I take twice as much time on as I used to on my school work. I have gather all information and talk it out to myself.”

Dr. Schnyer said that at UT Austin, the specific research process begins at Brackenridge Hospital, where the hospital generates the participants. He says the types of participants range from those diagnosed mild to those who have been admitted to ICU.

However, the only condition is that the participant must been only seen at Brackenridge within 24 hours after the initial hit of the head, and the process starts immediately.

The participant engages in a three part testing that consists of a neuro-psych test, blood serum draw, and MRI imaging. After two weeks the process is repeated, then after three months a survey is conducted.

Additionally, at the six, nine, and 12 month mark the three part testing is completed again. Dr. Schnyer said once the data has been collected, it is sent to a larger database to be analyzed by other researchers.

After working with these participants Dr. Schnyer said that

“You see the human toll on this disorder,” Dr. Schnyer said.

Schnyer emphasized it is, “absolutely fundamental we do this kind of research in order to implement appropriate treatment in the future.”

From first hand experience, Cyndi described what the toll is like for these TBI patients.

“I have seen people not remember things such as what they did same day to people not remembering who they are,” Hale said.

Hale said concussions can cause depression to the point of suicide. She said she has seen effects of concussions cause people to not even be able to cook themselves a bowl of soup on the stove without the fear of burning their house down.

“I have seen patients come in and just cry every time they are here [Carolina Neurology and Spine Associates] because before the accident they were fully functioning people and now they cannot survive without constant supervision from a family member,” said Hale.

Roossien said he spend most of his summer resting and preparing academically with a tutor for his senior year.

It was a bit nerve racking because of the college application process and schoolwork load, but he relied on his faith and support of his family and close friends, according to Roossien

“When God closes a door, he opens a window,”Roossien said.

“Before my TBI I took a lot of things for granted, especially my brain, and now I value the ability to think and function like a normal human being.” Roossien said.

Today Roosien is a second year at the University of Texas at Austin and is part of the Plan II Program and Business Honors School.

In 2019, Dr. Schnyer says the researchers will reconvene to discuss progress and new information found on TBI.

Until then,Roossien said, “my hope is one day they’ll will be able quantify this injury.”