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Shattered Minds

Azriela Jaffe

A fall down the stairs, a blow to the head, a car accident — what happens to those who survive a traumatic brain injury? Will they ever recover completely? And most importantly, how can they be helped?

Wednesday, February 26, 2014

“Three weeks before her eighth birthday, our daughter was standing in front of our house, waiting to cross the street, when a car hit her. She flew eight feet in the air and hit the ground so hard, her brain rattled in her skull,” relates Mrs. Fraidi Schwarz of Monsey. “My little brother ran into the house to tell me about the accident. I rushed to Gitty’s side. She was lying in a fetal position with just a tiny bit of blood. She looked so peaceful. I yelled to call Hatzolah.”

Gitty, now 26, lives at home. She can answer simple questions, and take part in limited conversations. She helps her mother peel vegetables and fold napkins. Gitty is not depressed or angry, nor are her parents. This is not the journey they anticipated for Gitty, but it is her life, and they celebrate it.

 

Will She Ever Be Normal Again?

Gitty endured a traumatic brain injury (TBI), the leading cause of disability and death in children and adolescents in theUS. According to the Centers for Disease Control and Prevention, children from birth to four years old and those between 15 and 19 are at greatest risk. But in the blink of an eye, TBI can happen to anyone. And when it occurs, the ramifications are often severe.

“The brain has the consistency of formed Jell-O, a soft mass housed by a hard skull, with billions of nerve cells (or neurons), that interconnect and communicate,” explains Dr. Jessie Simantov, medical director of Polytrauma and Traumatic Brain Injury for the James J. Peters VA Medical Center in the Bronx. “Damage to the brain potentially interferes with any function the brain controls.”

The damage is not necessarily limited to the point of contact. “Most traumatic brain injuries occur secondary to a trauma when external forces cause bleeding, swelling, or direct nerve damage,” explains Dr. Dalya Chefitz, a pediatrician and wife of Harry, a TBI survivor. “But traumatic brain injury can be caused by internal reasons as well. For example, if the brain is suddenly deprived of oxygen — and the situation isn’t rectified within minutes — it begins to undergo physiological changes that result in an acute injury also called traumatic brain injury.”

“The million-dollar question for every TBI patient is how much normal function can be recovered,” Dr. Simantov says. “Early on, when swelling and pressure go down, or when bleeding stops, some function is restored. Sometimes, remaining healthy brain tissue can take over the functions of tissue lost after injury [a process called functional reorganization] and compensate for damage to other areas. Various therapies and medications can help stimulate this process, which is why rehabilitation is so important to recovery.”

 

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