What is a TBI hematoma?

One of the possible consequences of a traumatic brain injury (TBI) is a hematoma. Most hematomas are as a result of some kind of trauma, although not all hematomas occur in the brain. You have probably had some type of hematoma before after a fall, bumping hard against something, or something hits you with some force.

A hematoma is blood that has leaked out of a blood vessel and collected in tissue, where is can cause some swelling or edema (fluid collection) and pain if the quantity of blood is large enough. It presents as a swollen area similar to a bruise, but a bruise is flat while a hematoma tends to be raised. A hemorrhage is the active leaking of blood outside a blood vessel; once it stops, then it is considered a hematoma if the blood collects in tissue.

While all hematomas are to be avoided, most will resolve without any medical intervention. In some cases when the hematoma is quite large, it may be necessary to cut into the tissue to relieve the pressure. Hematoma in the brain is considered the most dangerous because even a little pressure on the brain can have serious consequences.

There are three types of hematoma in the brain due to TBI: epidural, subdural and intracerebral. An epidural hematoma is when blood accumulates between the lining of the brain (dura) and the skull because of trauma to the temple. It develops relatively quickly. A subdural hematoma, on the other hand, progresses more slowly but because it is under the dura, it is more difficult to get to in case surgical drainage is necessary. The worst type of brain hematoma due to TBI is an intracerebral one, where the leak is happening inside the brain itself. Surgical drainage or a craniotomy may remove the leak, but often the damage to the brain has been done. However, in intracerebral hematoma cases where there is a significant amount of blood, the patient will not survive without surgical intervention. The size of the hematoma in the brain is determined with the use of a CT scan and MRI.

If you or someone you know sustained a traumatic brain injury due to the negligence of others, you may be facing considerable expenses for the treatment, recovery and long-term care resulting from brain damage. Contact a TBI lawyer as soon as possible to recover damages.

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Category D for Topamax Side Effects

Pregnant women are often vulnerable to side-effects for drugs they are relatively safe under different circumstances, such as the anti-epilepsy drug Topamax (topiramate). While the mothers themselves may not suffer permanent damage, birth defects can ensue with certain drugs. An unborn child is in rapid development; changes in the mother’s food and medication intake has a significant impact on the child. For this reason, the US Food and Drug Administration (FDA) created a categorization for drugs specifically for pregnant women.

There are 5 FDA pregnancy categories, ranging from “safe” (no evidence of risk of birth defects) to “dangerous” (clear evidence of high risk of birth defects). Prescription drugs that may have been in the market for years under a safe category may be moved to another category if there is new evidence regarding its effects on a pregnant woman. There have been numerous instances when this has happened, such as when adverse Topamax side effects began to emerge. Unfortunately, this means some harm has already occurred to either the mother or the child, and it is usually the child.

Category A is considered safe for pregnant women. The FDA does not actually call any drug “safe.” Rather, it states that studies “failed to demonstrate a risk to the fetus.” Category B drugs are also considered safe for pregnant women, except that the FDA qualifies that there have been “no adequate and well-controlled studies in pregnant women.” So if further studies show otherwise, the drug can be moved to Category C.

Category C drugs already demonstrated adverse effects on animal fetuses, although “no adequate and well-controlled studies in humans” have yet been carried out, and it is believed any risk is outweighed by the benefits of the drug. So this is more or less a tossup, and hopefully no real harm happens to the child or the mother with its use. Topamax used to be a Category C drug before complaints started to come in. It is currently a Category D, which has been shown to have “evidence of human fetal risk.” In the case of Topamax, it has been implicated in the increased number of children of mothers taking Topamax born with birth defects (oral-facial clefts). Even if a drug is under Category D, some physicians can still prescribe it provided the dangers are clearly explained to the patient.

Under Category X, however, the benefits of the drugs thus classified are considered to be outweighed by the risks it represents to pregnant women and their unborn children. Doctors will only prescribe this to women if they are not pregnant and under birth control medication, under strict supervision and if there is no other alternative.

Topamax manufacturer Johnson & Johnson has issued new labels in 2011 to reflect this risk, but for some children it may be too late. If you or someone you know has a child born with oral-facial clefts due to Topamax side effects prior to 2011, contact a birth defects lawyer in your area to see if you are eligible for a personal injury claim.

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