Dr. Edward R. Smith

Eddie Smith ~ Even Chairman

"Anytime that somebody hits their head and they're dazed, that is technically a concussion," said Dr. Edward Smith, a neurologist and neurosurgeon practicing in Santa Maria.

Look into the light: This is exactly what an injured Allan Hancock football player might see after stumbling off the field with an aching head: athletic trainer Cheo Munoz shining a light directly at his pupils.
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Commonly known as a bruise on the brain, Smith said the more accurate way to describe a concussion is a hit to the head that causes a loss of neurological function.
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Doctors first started to realize that concussions could cause permanent damage in the late '70s and early '80s, according to Smith.Effects have been studied since then and information from the Mayo Clinic confirms that there is evidence that people who have had multiple concussions over the course of their lives suffer cumulative neurological damage.

Still, there's only so much a person can do to protect his or her head.Most people have suffered a Grade I concussion at some point in their lifetime.These minor concussions are highly under diagnosed, according to Smith, and most of the time, that's fine by him.

"If everyone who had a concussion sought medical treatment, the system would be overwhelmed," Smith said.

Smith, whose patients are mostly older men and women, said he's surprised when he takes a case history and learns how many of them have hit their head during sports and didn't seek treatment.

"It's surprising how many of them were allowed to continue playing," he said.

The biggest challenge to parents and coaches is recognizing a concussion and making sure that kids recover fully before getting back in the game, Mu"oz said.Recovery includes rest, and taking Tylenol or ibuprofen, not aspirin, which thins the blood too much.Most concussions don't require medical attention, but if a concussion is severe or a person has symptoms for more than 24 hours, they should see a doctor, Smith said.

"I don't want to make too much of it because concussions are so common, but anyone who has cobwebs in their head for more than 24 hours should get checked out," Smith said.

It also ruled that the Weeks' expert, Dr. Edward Smith, was "not competent" to testify on the effect the error had on Mrs. Weeks and so dismissed his testimony.
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But the Supreme Court disagreed, noting that Dr. Smith was a neurosurgeon of considerable experience.He therefore qualified as an "expert" witness, the court decided.
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"The district court erred in failing to admit Dr. Smith's testimony as to the mechanical effects of the infusion because he based his testimony upon sound scientific principles," Schroeder wrote.
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"It also erred in holding that Dr. Smith's testimony was not admissible regarding the chemical effects because the adverse effects can be inferred from the facts known to Dr. Smith," Schroeder added.

3/01/07 (ID): Idaho Supreme Court Rules Expert Qualified Reversing an earlier decision, the Court ruled that expert Dr Edward Smith was indeed a competent expert in the case of Weeks v. Eastern Idaho Health Services (no. 32458).

Even Children's Hospital neurosurgeon Edward Smith doubted Robby Wright would survive the nightmarish backyard accident that left a pitchfork impaled in the Maynard 5-year-old boy's brain.
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"It was remarkable," Smith said yesterday."Most of these cases are lethal."

Even more stunning, Smith said, is that his former patient has recently returned to kindergarten and is learning how to read.
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"I told Dr. Smith, if I had to carry him the rest of my life, I didn't care, as long as he lived," Wright said.
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"Each week, the child proved me wrong," Smith said.

Shown from left to right: Dr. Edward Smith, Neurosurgeon -

Edward Smith (Harvard) 1953-54 -- New York
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Ed Smith (Harvard) 1951 by the New York Knicks

Edward Smith (Harvard) 1953-54 -- New York
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Ed Smith (Harvard) 1951 by the New York Knicks

"This is the kind of injury where time is of the essence," says Dr. Edward Smith, a neurosurgeon at Children's Hospital Boston and the man whom Robby's parents credit for saving their son's life.As Robby lay in a coma, the medical team had confirmed he had a large hemorrhage inside his head, and were very concerned because the pitchfork had penetrated the brain, increasing the risk of infection.
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"He went from someone I thought wouldn't survive, or if he did would be in a vegetative state with serious prolonged brain injury, to someone that completely astonished me," Smith says.

Harvard neurosurgeon Dr. Edward R. Smith told United Press International he and his colleagues have used the procedure , called hemicraniectomy , in 18 patients and the results are very promising.

He presented results from the first eight patients at the American College of Surgeons meeting in New Orleans.

He said hemicraniectomy is done as soon as the patient is diagnosed.The surgeons remove the skull flap , drain the blood from the brain and clip off the aneurysm to prevent additional bleeding.Traditionally , the skull flap is reattached at this point.

In the hemicraniectomy , the flap is removed and sewn under the skin of the abdomen , where it stays until it is reattached.Storing the flap in the abdomen serves two purposes : it keeps it with the patient and it keeps the bone sterile , Smith said.

The brain itself is covered by a leathery substance called dura.Surgeons add a graft to the dura so that it can expand if necessary.By leaving part of the skull open , physicians are able to accurately diagnose the two most common complications of brain hemorrhage : brain swelling or vasospasm.

Smith said the brain can swell days after the initial injury from the aneurysm.Vasospasm , which occurs when the blood vessels in the brain constrict , also takes several days to develop..Smith said it is very difficult to differentiate between the two because both have similar clinical symptoms : grogginess and confusion.

But if you don't know which symptom is present , you don't know what treatment to use , he said.

Treatment for vasoconstriction calls for increasing blood pressure and fluid volume , both of which are dangerous in a person whose brain is swelling.Conversely , treating swollen brains requires therapies that cause constriction of blood vessels , he said.

The brain flap is reattached nine to 12 weeks after initial surgery , said Smith.During that time people wear helmets to protect the brain , he said.

In a pilot study with eight patients who were already comatose when they arrived at the hospital , five of the eight are now back living normal , productive lives..

One patient is in fair condition and two are in poor condition , requiring constant nursing care.But historically patients with the same diagnosis would all be dead or in poor condition by now , the study said.

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Smith said that about one in 20 Americans have aneurysms , but only about 40 , 000 aneurysms rupture each year.

Most people live into old age with their aneurysms , he said.The initial symptom is the worst headache you ever had , he added.

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Smith said it was difficult to comment on Stone's condition , but he noted most people with subarachnoid hemorrhage are in very bad shape when the arrive at the hospital..

He added that hemicraniectomy should be reserved for those aneurysms that cause a large , very focal blood clot..