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INTRODUCTION

WHILE READING THIS book, if not already aware, you may realize that you or someone you know has suffered a traumatic brain injury (TBI) or concussion, in many cases without full knowledge that this condition exists. TBI is occurring at a rate much higher than previously believed and is now classified as one of the worst silent medical epidemics of our times. Poor surveillance systems worldwide, underreporting, and an improper definition of what constitutes an injury to the brain are all reasons for the limited focus on this condition. So, wake up, world, let’s pay attention!

The human brain is the one element in the universe that can both preserve and destroy mankind as we know it. It is a highly organized structure with over a hundred billion nerve cells (neurons) and about a thousand trillion connections between those nerve cells. This highly organized structure is the most important “computer processor” known to the universe, which defines who we are and what others perceive us to be. As highly organized as it is, the human brain can be damaged or destroyed by external forces in an instant.

The Brain Hierarchical Evaluation and Treatment (BHET) methodology has been developed by a board-certified neurologist, Dr. Kester J. Nedd, who has been treating persons with TBI and concussion in the USA for over 3 decades. Through his career, Dr. Nedd has had over 250,000 patient encounters with individuals who had a TBI or concussion. Dr. Nedd is an associate professor in the Department of Neurology at the University of Miami Miller School of Medicine and is the Medical Director of the USports Concussion Clinic, along with formerly being the Medical Director of the Neurological Rehabilitation and Intermediate Head Injury Unit at Jackson Memorial Hospital in Miami. At the time of publication of this book, Dr. Nedd was serving as Medical Director and Managing Partner of Design Neuroscience Center in Doral/Miami Florida, a center of excellence in TBI and concussion.

This work simplifies the complex subject of TBI and concussion, a subject that has been recently popularized by the media in conjunction with consumers and certain healthcare professionals. In its attempt to provide answers for complex unresolved questions, the BHET method deviates from the current linear approach in favor of a multi-dimensional approach. BHET is a transformative approach for the evaluation and treatment of patients by considering the hierarchical organization of the brain and how this hierarchy is impacted by injury and during recovery. It redefines the nature of TBI and concussion in the context of signs and symptoms, some of which are often missed in conventional intervention while also utilizing case reports of patients to illustrate important clinical principles. Based on the experience of Dr. Nedd and his colleagues, this method questions the current approaches and offers evidence-based, practical solutions that can be utilized by clinicians, patients and their families, the legal system, media, researchers, social scientists, medical professionals, individuals involved in the sports world, students, and policymakers when considering TBI and concussion.