Neurosurgeons propose a new framework for the assessment of traumatic brain injuries

Every year, almost 5 million adults and children are looking for medical care in the United States for traumatic brain injury.

After more than half a century, based on a data mountain, and a team of international experts, a new proposal, which was published in Lancet Neurology, has a new framework to revise how the injuries can be evaluated more precisely and the care of the patients can be better done.

The corresponding author for the new criteria is Dr. Geoff Manley. Manley is the head of neurosurgery at Zuckerberg General Hospital and professor of neurosurgery at UC San Francisco. He is also a member of the UCSF Weill Institute for Neurosciences.

Manley said the current clinical guidelines are not very precise.

For years, trauma centers have used the so -called Glasgow Coma scale to assess patients. Typically and generally patients with the measuring devices in three categories of TBIs: light, moderate or serious, and the patients are then treated accordingly, and according to Manley, this is a problem. He explained how some patients who were classified as “heavy” TBI are often addressed with a prejudices in the forecast, and the families are led to considering life support. Some of these patients have recovered and lived a full life. He added that he was added on the other side of the spectrum.

“And we know from studies that we have carried out in the past 10 to 15 years that a number of people with so -called mild TBA are actually not mild at all,” said the neurologist.

A typical example: Sean Sanford from San Francisco. Sanford writes Fiction and Music Reviews, is a substitute teacher and currently receives his master in creative writing.

He also loves skateboarding. 8 years ago he wanted to show his good friends a new trick, but he slipped, fell and hit his head on a concrete lead.

Sean was passed out. When he came up, he saw his friends and wife Candice standing over him, asked him if he recognized one of them.

“I have repeated myself again and again and how we don't like, where are we not? What's going on?” Sanford told.

His friends brought him to Zuckerberg. Clinic used the Glasgow Coma scale and rated Sean with poor concussion. Sean told CBS News Bay Area that he would be released and that the concussion should be able to break away with peace and time.

But Sanford told us that the team decided that they would scan his brain before you release him. The next thing he knew was brought to the operation.

“They sent me to an operating room, they called Dr. Manley, who did not work that day. They called him and they said we had a patient who broke his skull, and it is bad and if he is not treated, he will die”

Dr. Manley told CBS News Bay Area how SF General follows progressive protocols, but he wants other trauma centers, especially in rural areas, and the patients who offer them for better tools and a more precise probability of a reasonable assessment that provide the advantages and treatments. Some patients with light or moderate TBIs often develop symptoms long after they have been released from the hospital, and without follow-up or care they live a weak life.

An international coalition of experts and patients had the criteria. Manley is one of the corresponding authors. The new framework will soon be discontinued in the trauma centers in the USA on a voluntary basis.

The new criteria include what Manley and the report described as “4 pillars”: a clinical examination, biomarker blood tests that can have the level of tissue damage that contain certain tissue damage, and then “modifiers” that contain the age of a patient, gender, mental health, the support system and even earlier head injuries.

“We know that it is not just what the injury brings to the patient, but what the patient brings the injury,” Manley explained about the inclusion of “modifiers”.

In Sanford he needed aftercare. After the accident, he developed epilepsy and depression. It gets better, but it's a very slow process. Sanford now meditates and helps his wife in the family business in Divisadero to develop handmade products that promote relaxation.

“It is really a place of magic and a place of healing,” the writer noticed.

He still skateboards, but now, always with a helmet.