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Category Archives: Brain Injury

The Zackery Lystedt Law Now Law in All 50 States

Categories: Brain Injury

By PI-Advisor. Posted on .

On May 14, 2009, then Washington State Governor Christine Gregoire signed into law the “Zackery Lystedt Law.”  This first-in-the-nation law, prohibits youth athletes suspected of sustaining a concussion from returning to play or practice without a licensed health-care provider’s approval. The new law is the most comprehensive return-to-play law in the United States for athletes under 18.

In less than 5 years, all 50 states and the District of Columbia have passed a similar law.  This is the fastest growing public safety initiative to go into law in all states, ever.  Many states still don’t have seatbelt or helmet laws –  public safety initiatives that have been pushed for decades. 

Zackery Lystedt and his parents, Victor and Mercedes Lystedt, made it their mission to ensure no family has to go through what they went through.   On October 12, 2006, Zackery suffered a life-threatening brain injury during a middle school football game.  School coaches returned him to play football after he sustained a concussion, without first obtaining a complete evaluation by a licensed health care professional trained in the evaluation and management of concussions.  The young football star underwent emergency life-saving brain surgery at Harborview Medical Center after he collapsed on the field.   Zackery, now 21 years old, spends 40 hours per week working on his rehabilitation and taking college courses.

What’s next?  The Lystedts are pushing to bring the law to the US Congress and make it a federal law.  With the support of key national organizations including the NFL, CDC, USA Football, the United States Brain Injury Alliance just to name a few, the Lystedts believe it will happen.  The law is also catching on internationally with Canada and Australia calling for interviews with the Lystedts, Richard H. Adler, and Dr. Stanley Herring. 

Here are some recent reports on Zackery Lystedt.


Sports Safety Clinic for Presents, Athletes, Coaches & Community Parented by SafeKids Eastside

Categories: Brain Injury

By PI-Advisor. Posted on .

Richard H. Adler is an invited speakers at the Safe Kids Eastside Sports Safety Clinic for Parents, Athletes, Coaches & Community for Parents & Athletes on Tuesday, August 27, 2013 at Woodniville High School.  The clinic is sponsored by Evergreen Health and the Brain Injury Association of Washington and presented by Safe Kids Eastside.  Safe Kids is a worldwide non-profit dedicated to preventing injuries in children from motor vehicle collision, falls, sports, burns, drownings and more.  Safe Kids Sports Safety Clinic for ParentsAmall

Mr. Adler will present on the Zackery Lystedt Law, the nation’s first return-to-play law, which requires medical clearance of youth athletes suspected of sustaining a concussion before sending them back in the game, practice or training (2009).  Additional presenters include, The Lystedt Family (Brain Injury Awareness, Prevention & Safety Advocates; Zack is the inspiration and namesake for the ground-breaking health and safety legislation known as the “Lystedt Law,” that was signed by Governor Gregoire in May 2009); Stanley A. Herring, MD (Physical Medicine & Rehabilitation specialist; Co-Medical Director of the Seattle Sports Concussion Program; Clinical Professor University of Washington and a team physician for the Seattle Seahawks and Seattle Mariners; Member of the NFL Head, Neck and Spine Committee; “Lystedt Law” contributor and advocate); Darin Harris (Former UW Husky Football player who suffered a Traumatic Brain Injury his senior Current Board Member – Brain Injury Association of Washington); and Anthony Green (Director, Public Policy for Safe Kids Worldwide; worked in senior roles in the Congress, at the U.S. Embassy in Rome, as a “founding father” of the National Constitution Center and an award-winning reporter for Philadelphia magazine).

This event is open to the public but space is limited.  Pre-registration is not required but is appreciated.  To registration send an email to

Bicycle helmet laws linked to fewer child deaths

Categories: Bicycle Injury, Brain Injury

By Jacob W. Gent. Posted on .

HelmetAccording to a new study, state laws requiring children and teenagers to wear helmets are effective in reducing the number of deaths related to incidents involving bicycles and cars, according to a new study.   Researchers analyzing the number of bicycle deaths between 1999 and 2010 found that states with bicycle helmet laws reported about 20 percent fewer bike-related fatalities involving riders under 16 years old.

Approximately 900 people die as a result of bicycle-related crashes every year in the United States.   Three quarters of these fatalities are caused by head injuries.  Previous research found that wearing a helmet reduces a person’s risk of a head or brain injury by up to 88 percent.

Researchers analyzing data tracking the number of traffic-related deaths nationwide compared the number of children and teenagers killed while riding bicycles in the 16 states with helmet laws enacted in 1999 with states without such laws.

In 1999, only 16 states had helmet laws in place.  The overall rate of bicycle-related child deaths in the U.S. was 4 per million.  Between January 1999 and December 2010, there were 1,612 bicycle-related deaths among children younger than 16 years old.  During that time, states with helmet laws reported 2 bicycle-related deaths per 1 million children under age 16 years old, compared to 2.5 deaths per 1 million children in states without helmet laws.

The American Academy of Pediatrics recommends children wear a helmet approved by the Consumer Product Safety Commission every time they ride a bicycle.

Low-Pressure Hyperbaric Oxygen Therapy Reveals Promising Results for Soldiers with Blast Injuries

Categories: Brain Injury

By Arthur D. Leritz. Posted on .

Tragically, blast induced TBI and PTSD have been dramatically on the rise since the wars in Iraq and Afghanistan.  A recent Rand Report estimated that 18.3% of military service personnel deployed to these war zones have PTSD or major depression, and 19.5% have experienced a TBI.

Hyperbaric Chamber

A 2012 study on the safety and efficacy of hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI), post concussive syndrome  (PCS) and post-traumatic stress disorder (PTSD) indicated that several symptoms were reduced by undergoing this therapy.[1]    HBOT is a medical treatment that uses greater than ambient pressure oxygen as a drug by fully enclosing an individual in a pressure vessel and then adjusting the dose of the oxygen to treat pathophysiologic processes of diseases.

The study was done with 16 participants, all male, with the average age of 30.  All subjects were either active duty military or recently discharged active military.  All of the participants had sustained at least one brain injury.  Fourteen of the subjects had a pre-study diagnosis of TBI/PCS with PTSD, and two of the subjects had TBI/PCS.

Treatment for the subjects during the study consisted of 2 HBOT sessions, twice a day, 5 days a week.  Each HBOT session lasted 60 minutes.  Participants completed 40 HBOT sessions in total.  At the end of the study, 12 of the 15 subjects reported improvement in their symptoms.  Short temper/irritability, mood swings, imbalance, photophobia and depression, which were present in a majority of the subjects, were improved 44-93%.  Additionally, 64% of the subjects who were on psychoactive or analgesic prescription medication before HBOT decreased or discontinued their medication during the study.  Of those participants who noted improvement in their symptoms following the study, 92% still reported improvement six months after the study.  Sixty four percent of the subjects on psychoactive and narcotic prescription medications were able to decrease or eliminate the use of these medications.

While this was just a small test group, the results seem promising and I am sure more research and study will be occurring in the years and months ahead.

[1] Harch PG, Andrews SR, Fogarty EF, Amen D, Pezzullo JC, Lucarini J, Aubrey C, Taylor DV, Staab PK, Van Meter KW, “A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder.” J Neurotrauma. 2012 Jan 1;29(1):168-85. doi: 10.1089/neu.2011.1895. Epub 2011 Nov 22.

New Protections for Baseball Pitchers

Categories: Brain Injury

By Melissa D. Carter. Posted on .

Mention traumatic brain injury and student athletes, and few people think about baseball.  However, balls struck off aluminum bats can reach speeds close to 100 mph, causing serious risk of injury to the pitcher.

In October, 2012, Major League Baseball announced that it is looking for ways to protect pitchers from line drive injuries to the head, such as the injury to Tigers starting pitcher Doug Fister from a line drive during the World Series.  MLB is considering a variety of head gear for pitchers, including cap Kevlar liners.

Little league is ahead of MLB, with many youth leagues across the country requiring young pitchers to wear protective head gear while on the mound.  In 2010, high school pitcher Gunnar Sandberg was sidelined when a line-drive traveling at over 100 mph struck his skull, causing a life threatening traumatic brain injury.  A year later, Gunnar returned to pitching, wearing a 5 pound helmet to protect his skull.  President of Little League Baseball, Stephen Keener, is hopeful that this will catch on with younger players.

The youth pitching helmet was first designed by Easton-Bell as part of a movement to reduce traumatic brain injuries to student athletes.  The helmet is made from expanded polystyrene, a lightweight material adept at absorbing energy:

baseball helmet

National Summit on Sports Concussion

Categories: Brain Injury

By Richard H. Adler. Posted on .

The 6th Annual National Summit on Sports Concussion & Other Athletic Injuries: Established and Emerging Science for Return-to-Play takes place on June 22, 2012 in Los Angeles, CA.  I am pleased to be an invited speaker on few topics including “Mandating Player Safety by Increased Accountability for Non-Compliance on the Sidelines and Exam Room” and demonstrating a “Cross Examination in a Concussion Case”.   The Summit will draw from top leaders in sports concussion evaluation, treatment, and research.  Medical specialists, research scientists, legal advocates and those that work in the insurance world are scheduled to speak as well.  It will be a day of collaboration to help prevent preventable brain trauma and make sports safer and fun for all ages, particularly youth athletes.  For more information, please visit the Sports Concussion Institute’s website.

Sports Concussion Institute

Concussion and Girls Youth Soccer

Categories: Brain Injury

By Jacob W. Gent. Posted on .

Concussion strikes not only male football players, but athletes of both sexes in almost every sport.  Youth soccer has become increasingly popular over the past several years, and more girls are playing the game than ever before.  Currently, girls make up 48 percent of the more than 3 million soccer player registered in US Youth Soccer leagues.

Hundreds of girls across America suffer concussions while playing soccer each year.  “People who think of concussions as only being present mostly in guys and mostly in the sport of football are just plain wrong,  Soccer is right at the top of the list for girls.” Robert Cantu, MD, Chief of  Neurosurgical Service and Director Service of Sports Medicine at Emerson Hospital in Concord, MA, stated recently in a recent Rock Center with Brian Williams report.  According to Cantu, the country is in the middle of a “concussion crisis” with girls reporting almost twice the number of concussions as boys in sports played by both sexes.

Girls soccer has the second highest rate of reported concussions in young athletes according to another recent study in The American Journal of Sports Medicine.  Heading in soccer is a major cause of concussion.   When heading, players use their head to direct an airborne ball, often jumping in a group, which can cause collisions between players, strained necks, and banged heads.

Dr. Cantu says that the act of heading is one of the most dangerous parts of soccer and has recommended heading be eliminated from youth soccer under the age of 14. He also stated girls are more susceptible to concussion as a result of their anatomy.  “Girls as a group have far weaker necks.  The same force delivered to a girl’s head spins the head much more because of the weak neck than it does the guys.”

“What’s happening in this country is an epidemic of concussions, number one, and the realization that many of these individuals are going to go on to post-concussion syndrome, which can alter their ability to function at a high level for the rest of their lives,” Dr. Cantu said.

Concussion crisis growing in girls’ soccer – Rock Center with Brian Williams

Visit for breaking news, world news, and news about the economy

1. growing-in-girls-soccer?lite

2. Trends in Concussion Incidence in High School Sports, Andrew E. Lincoln, ScD, et al, American Journal of Sports Medicine, January 2011, Vol. XX, No. X.

3.  Epidemiology of Concussions Among United States High School Athletes in 20 Sports, Mallika Marar, et al, The American Journal of Sports Medicine, April 2012, Vol. 40, No. 4.

The Zackery Lystedt Law – Three Year Anniversary Update

Categories: Brain Injury

By Richard H. Adler. Posted on .

Its been almost three years since Washington State Governor Christine Gregoire signed the first-in-the-nation law protecting youth athletes and concussion by removing the child from a game or practice after a concussion and requiring medical clearance by a licensed healthcare provider.  The law was named after Zackery Lystedt.  Since that day, the three key components of the Zackery Lystedt Law are now law in 36 states (most recently Hawaii and Florida) and the District of Columbia.  Since 2009, the Lystedt Family continue to spread their message to ensure that all youth athletes are protected from experiencing the same tragedy by preventing preventable brain injuries.  Richard H. Adler, as Chairman of the Brain Injury Association of Washington has worked with many other coalition partners, including Stan Herring, MD (UW Medicine/Seattle Seahawks Team Physician), over the last three years have with countless Monday lunch phone conferences, presentations, and traveling to deliver the message, “when in doubt, sit them out.”

USA Football reported on the Zackery Lystedt Law, three years later.  Click here to read the full article.

Some Facts and Stats on Traumatic Brain Injury

Categories: Brain Injury

By Jacob W. Gent. Posted on .

Traumatic Brain Injury (TBI) is a contributing factor to a substantial number of deaths and permanent disabilities each year.  A TBI is caused by a bump, blow, jolt or penetrating injury to the head.  The severity of a TBI may range from “mild” to “severe.”

There are an estimated 1.7 million TBI-related deaths, hospitalizations, and emergency department visits occur in the U.S. each year. Nearly 80% of these individuals are treated and released from an emergency department.  TBI is a contributing factor in one-third of all injury-related deaths in the United States, or about 52,000 deaths annually.[1]

TBI injuries result form a number of causes. Falls are the leading cause of TBI, resulting in over  520,00 TBI-related emergency department visits and 62,000 hospitalizations each year. TBI rates are highest for children aged 0 to 4 years and for adults aged 75 years and older.

Motor vehicle-related injuries are the leading cause of TBI-related deaths.  Motor vehicle–traffic injury rates are highest for adults aged 20 to 24 years.

According to data collected by the Center for Disease Control and Prevention, there was a 14.4% increase in TBI-related emergency department visits and a 19.5% increase in TBI-related hospitalizations  between 2002 to 2006.  Emergency department visits for fall-related TBI saw a dramatic increase between 2002 and 2006. There was a 62% increase in fall-related TBI injuries for children 14 years and younger, and a 46% increase for adults aged 65 and older; 46%.  Hospitalization for fall-related TBI rose 34% while fall-related TBI deaths increased 27% from 2002 to 2006.

Direct medical costs and indirect costs of TBI, such as lost productivity, totaled an estimated $60 billion in the United States in 2000.

There are a few simple things everyone can do to reduce the risk of traumatic brain injury, including:

  1. Wearing a seat belt every time you drive or ride in a motor vehicle;
  2.  Never driving while under the influence of alcohol or drugs;
  3. Wearing a helmet and making sure your children wear helmets when:
  • Riding a bicycle, motor cycle, snowmobile, scooter, or ATV;
  • Playing contact sports of any kind;
  • Using in-line skates or a skateboard;
  • Riding a horse;
  • Skiing or snowboarding.

4. Make living areas safer for infants and seniors by:

  • Removing tripping hazards such as throw rugs in walkways;
  • Placing  nonslip mats in the bathtub and on shower floors;
  • Installing grab bars in the tub or shower and next to the toilet;
  • Installing handrails on both sides of stairways; and
  • Improving lighting throughout the home.[2]


[1] CDC. Ambulatory Health Care Data.


ESPN SportCenter Special Report on Zackery Lystedt and Safety in the NFL

Categories: Brain Injury

By Richard H. Adler. Posted on .

Whether you are a sports fan or not, when ESPN covers a story, people listen.  This is especially true the week before the Super Bowl, so when ESPN chose a special story to air during the week leading up to the big game, you just know it is important and a ‘must see.’  Last week ESPN travelled to Maple Valley, WA to do an interview with Zackery Lystedt and his parents, Victor and Mercedes, as part of a special report for its “SportsCenter” television show.  The report focused on “Safety in the NFL,” and the recent and future rule and equipment changes to make the game safer for players at all levels and ages.   The change started in Washington and with Zackery Lystedt.  Two years ago the NFL Commissioner, Roger Goodell, came to Seattle, WA as an Honorary Chair of the Brain Injury Association of Washington’s Annual Fundraising Gala.  Mr. Goodell met Zack, medical specialists, and advocates and credits this visit with changes we are now seeing in the NFL.  The 45 minute episode on ESPN contains a 5 minute feature story on the Lystedts, the law named after him, the Brain Injury Association of Washington, and how the NFL is changing the game.  Zack’s story is one worthy of your time and one that will warm your heart.

ESPN SportsCenters Special Report – Life Changed by Concussions