It's disheartening for physicians like Dr. David Wright to have to tell families with a loved one with severe TBI that, to date, there is no definitive treatment besides waiting and offering support.
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When a patient comes in the emergency department,
we evaluate them
based on the Glasgow Coma Scale.
So, we're just trying to codify their injury--
--are they severe, are they moderate,
or are they mild?
Depending on where they fit in there
depends on, obviously, what interventions
we do, and what's needed.
I think, probably, the saddest thing
is that we really have no treatment available,
and depending on whether you're mild, moderate or severe,
basically what we're doing is supportive care.
Throughout their hospitalization
that's all it is, it's supportive care
and preventing anything from worsening
the injury or any other bad thing
from happening to them,
but the reality is, there is no drug available
to treat them with
acutely and to prevent ongoing damage.
So, part of the reason
it gives me passion
in studying traumatic brain injury,
is that every time I have to go to a family member
and tell them that their loved one
has had a bad brain injury,
and there's not really anything we can do,
other than to sort of wait and support them
and see what happens,
that's really disheartening.
It's frustrating as a physician because you want to do something,
and it's devastating to the family.
There's just not a lot of hope.
So, that's why we're working,
many of us, working very hard
to try to find a treatment
for this devastating disease.
The most important changes over the last 10 years,
has been awareness,
and if there's silver lining to
OIF and OEF, the Iraq and Afghan conflict,
it is that it has brought to light
the importance of traumatic brain injury,
especially mild traumatic brain injury,
and what the laypeople in sports, we call it concussion.
Concussion is essentially a traumatic brain injury.
So, it has brought it forth.
People now have a recognition of it,
an awareness that it's a problem,
and that has really helped us in the research realm.
First of all, getting access to patients
and to subjects.
Second of all, in funding,
in putting money towards research in this area
which had been left alone for many years.
In fact, the CDC,
prior to OEF, called
traumatic brain injury the 'silent epidemic,'
because it was
devastating, causing huge problems,
and nobody paid attention to it.
So, that's been the best thing that's happened
over the last 10 years.
From a research standpoint,
we're just getting going.
There is a lot of great stuff.
We're learning more about the pathology
and the pathophysiology
and about mechanisms,
targets that we can use.
The polydrug, the multidrug approach
is now being accepted as a legitimate approach,
which is great.
New detection devices are being developed
to help us with our concussion assessments.
Produced by Victoria Tilney McDonough, Ashley Gilleland, Justin Rhodes, and Erica Queen, BrainLine.
David Wright, MD, FACEP is a tenured associate professor in the Department of Emergency Medicine at Emory University, and the director of the division of Emergency Neurosciences. The Emergency Neurosciences program is dedicated to finding novel therapies for the treatment of rapidly evolving neurological conditions, including traumatic brain injury, stroke, status epilepticus, spinal cord injury and others.
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