Mild traumatic brain injury and concussion is the most common combat-related injury. Traumatic brain injuries (TBI) and spinal cord injuries account for nearly 25 percent of combat casualties. Better body armour and the use of Kevlar helmets do protect troops and they have saved the lives of many men and women in areas of conflict like Afghanistan and Iraq, as has improved medical care. But helmets and body armour cannot protect the frontal area of the head, the face and the exposed area of the spinal cord. The result is that more and more soldiers are surviving, but some are left suffering the long-term effects of severe brain damage.
Traumatic brain injuries that occur in combat are often complex. Sudden air pressure changes following a blast cause internal and external injury; the explosion can injure the brain, producing concussions (traumatic injury to tissues) or contusions (bruising). Injuries may then be worsened by flying fragments, then more damage can occur when a soldier's body is physically propelled, possibily hitting the head against another hard surface-something unlikely to happen outside of war zones.
Signs and Symptoms of Traumatic Brain Injury
A traumatic brain injury is defined as an insult to the brain caused by an external force. This force may produce a diminished or altered state of consciousness, resulting in impaired cognitive abilities and/or physical functioning. These changes can include problems with thinking, sensation, movement, language and concentration. Brain injury can result in personality and emotional changes, irritability, tiredness, depression, violence, disinhibited behavior and the inability to carry out basic, everyday tasks.
The brain is a complex organ and the damage caused by TBI can sometimes seem really bizarre. Areas of previous functioning may be intact, like driving a car, but someone may not be able dress properly or carry out the job they used to do before. Another person may be able to do their job with no problem but their personal relationships are changed profoundly. (One of the strangest types of damage from traumatic brain injury that I have seen is someone with so called 'blind sight'. This is where a person believes they are blind, yet they can 'see' to follow an object around a room, walk down the street, and never bump into any object. The brain is receiving information from the eye yet the connections from the part of the brain that 'sees' is severed or so severely damaged that the person does not perceive the sensation of sight.)
Signs and symptoms of TBI will depend on the extent of the damage to the brain. In war, blast injuries can result in multiple traumas, a.k.a. polytrauma. There are injuries to internal organs, limb loss, sensory loss and psychological disorders. Blasts produce huge external and internal forces that can cause great damage and penetrating injuries to the brain, not only producing focal damage but also infection.
Most symptoms will be obvious immediately after an injury, but sometimes symptoms may appear only after days or weeks following the injury. People may not admit or recognize difficulties following a brain trauma and the brain can also play tricks. Sometimes when people have deficits in memory, they 'fill in' the gaps, a process known as confabulation. They do not realize they are doing it, and unless you know someone well and know what they have been doing, their accounts of their lives can appear completely normal.
Recovery Prognosis Following Traumatic Brain Injury
For most troops with post-concussion or mild TBI, recovery time will be within a few weeks or months, although a small percentage will have persistent symptoms. Patients with moderate to severe TBI may never fully recover their pre-injury function. Their lives and the that of their loved ones will have been permanently changed. Many troops who go to war and have severe TBI will require a life time of health support services and treatment.
Article Sources Include:
Wood, Ken. "Traumatic Brain Injury National Data Center (TBINDC)." 11 August 2006. United States Department of Veteran Affairs. 18 Oct 2006 http://www.virec.research.va.gov/Non-VADataSources/TBINDC.htm.
"National Center for Injury Prevention & Control." What is Traumatic Brain Injury?. 07 September 2006. Centers for Disease Control and Prevention. 18 Oct 2006. http://www.cdc.gov/ncipc/tbi/TBI.htm.
Margolis, Jason. "US Veteran Brain Injury News." Traumatic Brain Injuries in Soldiers Often Go Undetected. Brain Injury Resource Foundation. 18 Oct 2006 http://www.birf.info/home/library/vet/vet-undetected.html.
