Dr. Arno Fried was a featured presenter at a conference for medical professionals on May 8, 2014 held in Jersey City. Dr. Fried’s presentation, “Current Trends in Traumatic Brain Injury”, a lecture topic on which he has spoken numerous times, was part of an inaugural conference featuring medical experts from the area, as well as from Pennsylvania, Chicago and Reno.
The conference, titled “Yesterday, Today & Tomorrow—Celebrating 20 Years of Trauma Care,” was sponsored by Jersey City Medical Center’s The Port Authority Heroes of 9/11 Trauma Center, and took place at the elegant Liberty House Restaurant located near Liberty State Park in New Jersey.
Dr. Fried, a veteran of about two-dozen such presentations per year, spoke to approximately 150 audience members. The audience was comprised of physicians, surgeons and nurses. The conference, which provided professional credits to those in attendance, was designed to describe current treatments as well as medical advancements, and in the case of Dr. Fried’s presentation, in particular, current trends in neurosurgical trauma care.
Dr. Fried began with sobering statistics: there are 4.5 million head injuries per year in the U.S. and 1 million of those are children, for whom head injuries are the leading cause of death. The notable phrase of his presentation was: ‘Time is Death’, which speaks to the urgency of care. Dr. Fried included these statistics:
For every minute’s delay, the brain loses:
- 1.9 million neurons;
- 14 billion synapses;
- 7.5 miles of myelinated fibers.
According to Dr. Fried, head injury among both adults and children is very commonly seen in his practice, Advanced Neurosurgery Associates, and trauma makes up 20 percent of his practice. Dr. Fried outlined the various brain injuries, from types of fractures and hematomas to Shaken Baby Syndrome, as well as the various and most current means of evaluation and surgical care.
Early in Dr. Fried’s career, during the 1980s, he conducted two years of research on the physiology of intracranial pressure and the use of pressure monitoring for the management of head trauma. His unique and cutting-edge approach to brain compliance (the capability to buffer an intracranial volume increase while avoiding a rise in intracranial pressure) was the subject of various pilot studies on which he bases his current treatments. His treatment recommendations include the use of pressure volume index (PVI), a useful tool to measure brain compliance and which he has used to perform lifesaving care. Dr. Fried has found PVI, his predictive measure, to be a much earlier and accurate guideline to care. In addition to brain trauma, brain compliance is also of major relevance in other common neurosurgical conditions such as hydrocephalus and pseudo tumor.
An example is Kevin, who received care from Dr. Fried. Here is Kevin’s story, according to Kessler Institute for Rehabilitation:
It was just another night out for Kevin and his friends until they were targeted and brutally attacked as they left a restaurant. Kevin, a recent college graduate who was in a financial services training program, was jumped from behind and beaten. His injuries were massive: multiple fractures of the skull and jaw, bilateral subdural hematomas, left subarachnoid hematoma and a concussion.
Rushed to Jersey City Medical Center, Kevin underwent a craniectomy to relieve pressure on his brain. He remained in a medically induced coma for four weeks, developed acute respiratory distress syndrome. His doctors weren’t sure he’d survive.
But Kevin defied the odds.
At Kessler, he began an intensive brain injury rehabilitation program. He recalls feeling lost, helpless and in many ways hopeless. But with individualized care, he was able to recover some of his strength, skills and function, and relearn how to walk.
To Kevin, his progress seemed frustratingly slow. It was difficult and often very painful, but he never gave up. His personal determination and hard work, combined with the support and prayers of his family, friends, and medical and rehabilitation teams, have helped him begin to rebuild his confidence … and his life.
Lucky to be alive, Kevin cautions, “Don’t wait to do what you love; you never know when you might not be able to do it.”
In addition to traumatic brain injury (TBI), Dr. Fried’s presentation also included the topic of Mild Head Injury (MTBI), including concussions, and reiterated that a person should remain symptom-free for at least two weeks before engaging in activities putting one at risk. He acknowledged the highly-publicized issues surrounding brain injury that have been brought to light by professional athletes, and specifically warned of the need to avoid Second Impact Syndrome (repeat concussion before the brain has healed), which can be fatal.