Aggressive behavior after traumatic brain injury, whether it comes in the form of physical or verbal expressions, can interfere with family life, rehabilitation, and recovery. Prevention of aggressive behavior after traumatic brain injury is important, and yet how exactly aggressive behavior was related to injury had not previously been explored.

A group of researchers from Johns Hopkins School of Medicine recently reported the prevalence and specific risk indicators of aggression after traumatic brain injury. The following summarizes their results:

1. Verbal aggression was quite prevalent after traumatic brain injury, but physical aggression was nearly absent.
2. Aggression was associated with:
   1. Impaired psychosocial functioning
   2. New-onset major depression
   3. Increased dependence in daily living activities
   4. Major depression that occurred before injury was not a predictor of aggression.
   5. Aggression was not associated with pre-injury behavior problems, substance abuse, legal charges, or neuropsychological tests.

These associations mean that aggression after traumatic brain injury could potentially be addressed by alternative methods, such as providing stronger social connections, increased independence in daily living, or direct treatments of depression. Additionally, their research dissociated the social or pre-injury factors commonly thought to magnify aggressive behavior.

Rao V, Rosenberg P, Bertrand M, et al. Aggression after traumatic brain injury: Prevalence and correlates. Journal of Psychiatry and Clinical Neuroscience. (Fall 2009).

Whether you promise to pick up milk after work, or you make doctor’s appointment for the next day, a little post-it note forms in your mind to remind you of the task. And hopefully, that post-it note will signal you to remember that task at the right time. This process of remembering to remember is called prospective memory. And it’s commonly impaired in people with traumatic brain injury.

Prospective memory impairment in mild traumatic brain injury has only recently been studied. The Journal of Neurotrauma published a study that suggests that people with mild traumatic brain injury show immediate problems with prospective memory, which persist even after 3 months.

Prospective memory is based on a complex system of cognitive process: intention, initiation, attention, appropriate sense of time, and proper recall of events. Given this complexity, prospective memory impairment (or forgetting to remember) can also be an indicator of general cognitive impairment in mild traumatic brain injury. The authors of the study suggest that prospective memory assessments, such as the Memory for Intentions Screening Test, could be used as a sensitive tool for diagnosing cognitive impairment in mild traumatic brain injury.

Tay SY, Ang BT, Lau, XY, et al. Chronic impairment of prospective memory after mild traumatic brain injury. Journal of Neurotrauma. (January 2010).

San Francisco based trial lawyer Randall H. Scarlett, principal of The Scarlett Law Group, testifies before the California Senate Health Committee with Recommendations Regarding State Facilitated Treatment of California Survivors of Traumatic Brain Injury

For the first time in California’s history, the Senate Health Committee undertook extensive preliminary hearings yesterday on the issue of  Traumatic Brain Injury and its impact, fiscally and otherwise, on the State of California. These historic hearings involved approximately two hours of testimony and presentation by physicians and by members of the California Brain Injury Association. The hearings, promised to be the first in a number of educational and exploratory hearings on Traumatic Brain Injury, were telling as to the staggering costs associated with the treatment of survivors of Traumatic Brain Injury.

For a view of the complete hearings please visit the following link:

The hearings involved the testimony of several board members of the California Brain Injury Association, including Dr. Mark Ashley, Dr. David Hovda, Sharon Grandinette, and Randall H. Scarlett. The California Brain Injury Association also invited Dave Woodruff, co-founder of the Bob Woodruff Foundation (and older brother of Bob Woodruff) in order to address Traumatic Brain Injury issues relative California’s returning veterans.

Several recommendations were made by CALBIA to the Senate Health Committee, including the formal formation of a Traumatic Brain Injury taskforce to advise the California Governor’s Office, Senate and Assembly on these important and fiscally demanding topics. The packed hearings promise to be the first in a number of such hearings likely to be held on this important topic.

Mr. Scarlett addressed the Senate Committee on the issue of mild Traumatic Brain Injury, concussion and insurance coverage issues such as exclusions under the term “medically necessary”. Mr. Scarlett also addressed the Senators on the staggering costs of care associated with Traumatic Brain Injury.

Randall H. Scarlett, principal, concentrates his practice in the areas of  catastrophic personal injury,  traumatic brain injury, spinal cord injury, wrongful death and other serious wrongs. The Scarlett Law Group also handles cases involving product liability, aviation disaster, medical malpractice, international human rights, domestic civil rights, environmental and complex consumer actions.

To view the California Brain Injury Association Handout for this hearing, please see: Senate Hearings