Recent news relating to traumatic brain injuries
There were two significant developments relating to traumatic brain injury in the past ten days. One was the long-awaited publication of a study authored by the Boston University Center for the Study of Traumatic Encelphalopathy, while the other was the even more delayed announcement of new Department of Veterans Affairs regulations on the subject of TBI and disability.
The Boston University study addressed brain samples from 85 individuals with histories of repeated mild traumatic brain injury. It doubled the number of known cases of chronic traumatic encephalopathy (CTE). 65 of the 85 subjects were men and 80 percent showed some evidence of CTE. Nearly all of those affected had played sports (six high school football players, nine college football players, 33 NFL players, seven pro boxers and four NHL veterans). 21 subjects with CTE were also military veterans.
Authors of the study created a four-tier system of categorization: Stage 1, headaches and loss of concentration; Stage 2, depression, explosive impulsivity and short-term memory loss; Stage 3, cognitive impairment and impairment of executive function; Stage 4, full-blown evidence of dementia. The authors concluded that CTE is probably "more widespread than we think" and that the ultimate cause is total brain trauma and management, including both major concussions and smaller sub-concussive hits.
The new DVA rules will disappoint many head injury advocates but still represent a much needed half-measure of improvement. They will make tens of thousands of veterans eligible for benefits while also making assistance for some veterans more difficult. This is primarily because of the categorization used by the VA to define compensable brain injury. The regulations limit time periods for making claims and also require documentation that will render many head-injured veterans ineligible for benefits.
For example, veterans with Parkinsonism, unprovoked seizures, dementias or hormone deficiencies will be eligible only if their TBI was classified as "moderate" or "severe." They will need to document a loss of consciousness (LOC) lasting 30 minutes or more to establish a moderate brain injury and a LOC lasting 24 hours to show that a severe TBI has been suffered. Furthermore, the symptomatology of injury must become apparent within 15 years of the moderate or severe TBI and hormone difficulties must be apparent within 12 months. Depression must be documented within three years of the TBI, which, again, cannot be merely a "mild" TBI.