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 TBI and SCI Research
Spinal Cord Treatments
Brain Injury Treatments
Rehabilitation
Medical Rehabilitation
Community Rehabilitation
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Treatments
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Brain and
Spinal Cord Injury Research
Although these
are two separate injuries the result can often be the same,
paralysis and damage to nerve cells that do not regenerate.
Therefore, much of the advances in research are advances for
both injuries. Some of the most promising research is that
of stem cells
 Stem Cell Research
Currently stem cell
research is offering new hope to those afflicted with brain
and spinal cord injuries. The idea is that by implanting
stem cells into the damaged area might help regenerate or
replace damaged tissue. Stem cells have been shown to make
new nerve and support cells, though they do not
automatically regenerate damaged nerves. One of the major
obstacles to overcome on this research is finding the stem
cell's identity and to produce a cell population that has a
higher concentration of stem cells, since they only occur at
a rate of 1 for every 300-brain cells (1).
Cnidarians
Another new discovery that could
aid in spinal cord and brain injury treatment is the link
between the DNA in cnidarians and humans. Cnidarians include
jellyfish, corals, and sea anemones, have nervous system DNA
that is very similar to that of humans, with one exception,
theirs regenerates (2). The idea is to find what causes this
regeneration and to hopefully be able to apply it to humans. |
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Spinal Cord Treatments
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Methylprednisolone
This treatment has been
found to be affective if administered within eight hours of
injury. This is a steroid that protects nerve cells from
damage due to inflammation, thereby reducing the amount of
paralysis(3). Another steroid called tirilzade, works in
much the same way as methylprednisolone, but has a smaller
window for treatment, and also has less side affects(3).
GM-1
This is a ganglioside used in
conjunction with methylprednisolone that aids in recovery.
It must be administered within 72hrs of the accident and
continued for 32 days (3). Research has shown that it is not
effective if administered with methylprednisolone, so it
must be used after the initial methyprednisolone
treatment(4).
Vaccination
An experimental vaccine has been
proven effective in preventing total paralysis in rats with
an injured spinal cord. This vaccine, made of myelin
peptide, boosts the body's immune system and helps prevent
continued damage to the spinal cord after the injury(5). The
vaccine is hoped to be made easy enough to administer, that
paramedics in an ambulance could do it.
Electrical Stimulation
Some research has
entered the realm of electrical stimulation. One is FES,
Functional Electrical Stimulation. FES uses implants to send
electrical impulses to nerves in the hands, arms, and legs.
This research is hoped to help gain the use "of a hand,
standing, and some stepping abilities, as well as bowel and
bladder function"(3). One device produced by the FES is the
FNS, Implantable Functional Neurostimulator. This device has
allowed certain individuals with quadriplegia limited use of
their hands(3).
Computer Chip Implants
Though years away
another possible approach is computer chip implantation. It
has been shown that even years after the accident, the areas
of the brain that control movement are still functional.
Therefore a computer chip could be implanted to receive
messages from the brain bypass the wounded area and send
them where they need to go. The chip will then send a
response back to the brain.
Embryo Cells
This is the most controversial
method of treatment. It has been found that embryonic cellos
help regenerate cells in the damaged area of the spine.
Because of the controversial nature of using human embryo
cells, researchers are now using the embryo cells found in
the blue shark. Although this method of treatment is
dangerous, time consuming and costly, researchers have seen
positive results. |
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Brain Injury Treatments
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Calpain Inhibitors
It has been found that
after a traumatic head injury certain chemicals are released in
the brain creating a biochemical storm. This storm can last up
to a month versus the two days it was originally believed to
last. Certain enzymes, calpains, go into over activity due to an
influx of calcium into the nerve cells. These calpains devour
important structural proteins in the brain. Scientists are now
working on calpain inhibitors, to prevent the destruction of
these proteins and continue the treatment for over a month(6).
Hyperbaric Treatment
It is important to note
that there are no known treatments for brain injury, just
hope. In hyper baric treatment the patient is placed in a
hyperbaric chamber, which pumps oxygen into the bloodstream.
The idea is the oxygen may revive dormant brain cells(7).
Currently there has only been minimal positive results using
this method, and it is still not known if dormant brain
cells even exist. |
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Rehabilitation
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| Rehabilitation plays an extremely important role in
dealing with brain injuries. As stated previously there are no
known treatments for brain injury, and it is important that the
person afflicted learn how to deal with his/her new disabilities
through rehabilitation. It is also important to note that
rehabilitation should be individualized, as every injury has its
own specific effects on the person. A person will have to
relearn how to function, sometimes this involves learning new
ways of doing things to compensate for abilities they may have
lost due to the injury. The idea is for the injured to become as
independent as their injury and will will allow. There are two
commonly used models of rehabilitation, Medically based and
Community based. All the information provided on these
rehabilitation models was taken directly from the Brain Injury
Association Inc.'s website, which can be viewed at www.biausa.org.
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Medical - Based
Rehabilitation
Early intervention is crucial
Rehabilitation
should ideally start in the Intensive Care Unit. At this point,
rehabilitation is generally preventive in nature. Range of
motion, bowel and bladder hygiene (i.e. initiation of regular
bowel program and removing indwelling catheters), prevention of
pressure sores, and orientation are all very important, right
from the beginning. Frequently, rehabilitation activities
initiated in the ICU can reduce complications and sometimes, the
length of hospitalization.
Acute Rehabilitation
Once a person is
medically stable, transfer to an acute rehabilitation facility
often occurs. There, he or she will spend several hours a day in
a structured rehabilitation program. This program usually
includes a team of professionals with training and experience in
brain injury rehabilitation. Additional staff support the brain
injury rehabilitation team's efforts, and often includes
respiratory therapy, pharmacy, lab, nuclear medicine and
radiology and even housekeeping, dietary and central supply.
"Subacute" Rehabilitation
People who are
minimally aroused for a prolonged period often have limited
attention and stamina, and need a less intensive level of
rehabilitation services, over a longer period of time. Subacute
rehabilitation may be provided in a variety of settings, but is
often in a skilled nursing facility or nursing home. It is
important to note that the services provided by subacute
programs vary widely, as there is no generally accepted
definition of subacute services at this time.
It is important to recognize that "more therapy"
does not
make a person "better", but that "appropriate"
therapy does.
Sub-acute rehabilitation programs require
the same appropriately trained professionals as acute
rehabilitation programs do. The goals of sub-acute
rehabilitation should include minimizing morbidity, maintaining
functional positioning, hygiene, nutrition, and medication
management, as well as providing support for the person with a
brain injury and his or her family. Sub-acute rehabilitation
programs may also be designed for persons who have made progress
in the acute rehabilitation setting and are still progressing,
but are not making rapid functional gains.
Day Treatment/Day Rehab
Day rehab (sometimes
called "Day Hospital") provides intensive rehabilitation in a
structured setting during the day and allows the person with a
brain injury to return home to their family at night. The
treatment team is often made up of a variety of trained
rehabilitation professionals. |
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Community - Based
Rehabilitation
Outpatient Facilities
Following acute
rehabilitation or sub-acute rehabilitation, a person with a
brain injury may continue to receive outpatient treatment in
specific areas (i.e. ongoing speech pathology to continue to
work on cognition, or occupational therapy to work on driving,
etc.). Often, this treatment can also be provided in the home by
a home-health agency.
Home-based Rehabilitation
There are a few
rehabilitation companies, which focus on providing acute
rehabilitation within the home, or community setting. Once
medically stable, some persons with a brain injury may be able
to participate in such a program, if there is such a program in
their community.
Community Re-entry
Community re-entry
programs generally focus on developing higher-level motor and
cognitive skills in order to prepare the person with a brain
injury to return to independent living and potentially to work.
Treatment may focus on safety in the community, interacting with
others, initiation and goal setting and money management skills.
Vocational evaluation and training may also be a component of
this type of program. Community Re-entry programs generally run
for part or all of the day, with participants returning home to
sleep and be with their families.
Independent Living Programs
Independent
Living programs provide housing for persons with brain injury,
with the goal of regaining the ability to live as independently
as possible. Usually, independent living programs will have
several different levels, for people requiring more assistance,
to those who are living independently and being monitored. In
addition to physical, occupational, speech and recreation
therapists, these programs usually have life skills technicians,
who assist the person with a brain injury towards independence. |
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| Above References / Works
Cited |
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- Author not available,
SCIENTISTS FOUND NEW METHOD TO CAPTURE BRAIN STEM
CELLS., Xinhua News Agency, 08-15-2001.
- Author not available, Qld: NEW
HOPE IN TREATMENT OF SPINAL AND BRAIN INJURIES., AAP
General News (Australia), 09-01-2001.
- Amanda Lynch, A CURE FOR SCI?
WHERE WE'VE BEEN AND WHERE WE'RE HEADED…HEADED…Vol.
43, Accent on Living, 12-01-1998, pp 28-34.
- Author not available, PROGRESS
BEING MADE ON SPINAL CORD INJURIES. Vol. 127 n, USA
Today Magazine, 10-01-1998.
- Author not available, SPINAL
VACCINE PRVENTS PARALYSIS IN RATS., United Press
International, 08-15-2001.
- Joyce Howard Price, BRAIN-INJURED
NEED LONGER TREATMENT; STUDY FINDS TISSUE DAMAGE LASTS A
MONTH., The Washington Times, 10-29-1999, pp A10.
- Ken Moritsugu, HYPERBARIC
TREATMENTAT NCMC / AN EXPERIMENT FOR STROKE VICTIMS.,
Newsday, 09-25-1997, pp A34.
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Information for this page was received
from biausa.org
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Brain and Spine
Injury Attorneys
San Diego Office
12555 High
Bluff Dr.
Suite 215
San Diego, CA 92130
New York Office
158 E. 35th St.
New York, NY 10016
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