TBI – Mechanism and Implications

Head injury in the military

80% of Traumatic Brain Injury among the military occur during training

In an excellent article on research being done to address Traumatic Brain Injury (TBI) in the military, The St. Louis Post-Dispatch presents efforts being made to identify the extent of the problem.

According to researchers there are four kinds of TBI — mild, moderate, severe and penetrating. Since 2000, nearly 300,000 active-duty military personnel have been diagnosed with TBI.

It wasn’t until 2008 that the Department of Defense began to enforce a police of mandatory post-deployment screenings for TBI; and then, in 2010, a mandate for across the board screenings of all personnel exposed to a blast within 50 meters was enforced. The

numbers are truly alarming. Yet these numbers mark hope for these soldiers whose performance is impacted post-injury and whose lives as veterans are impacted negatively, both at work and at home.

According to Katherine Helmick, deputy director of theDefense and Veterans Brain Injury Center in Silver Spring, Md., which was created by the government after the first Gulf War, “The natural trajectory is that you get better. It becomes more complex if you don’t get this detected early.”

Though there is a focus on the wars, 80 percent of military TBI diagnoses occurred in non-deployment settings, for instance in training. Scores of service members were never screened prior to the new policies and may be living with TBI. “I am sure the numbers are underreported,” Helmick said.

And in the civilian population

Traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability. Every year, at least 1.7 million TBIs occur either as an isolated injury or along with other injuries.

Brain Advanced Access (September 14, 2007), describes this phenomenon of chronic Traumatic Brain Injury in medical terms that the layperson can readily understand.

Neurobehavioural deficits, especially in cognition, are often the cause of significant disability after TBI (CDC, 2003). Observed cognitive changes that follow TBI can include decreased mental flexibility, trouble shifting sets, impaired attention, poor planning, lack of organization, problems with sequencing, impaired judgment, deficits in verbal fluency, problems with working memory, as well as increased impulsivity (Levin and Kraus, 1994; Miller, 2000; Godefroy, 2003).

So, really, that’s the point. Chronic repercussions of TBI include deficits that significantly impair everything about the routine lives of survivor.

So we know what it is… So what?

Diagnosis of TBI – getting to the bottom of it is one thing, but in the meantime, TBI sufferers are suffering.

TBI patients with or without an accurate diagnosis  are still living – and will continue to live with disturbing and disruptive symptoms that affect their professional lives, their social connections, their spiritual experience, their emotional wellbeing – as well as their day to day, routine activities of daily living. We wring our hands, trying to determine if some responsible party can be persuaded to offer sufficient benefits to offset the disruption to their health and their lives. And, for certain, those who have unwittingly sacrificed their very ’selves’ – in every sense of the word –  for our safety – or pleasure – deserve to be made as ‘whole’ as possible. But, of course, the fact is that you cannot place a dollar value on a person’t ability to fully experience the joys, the hardships and the routine of daily living.

Perhaps at some point in the future, diagnosis of the underlying organic pathology of TBI will lead to better understanding. Hopefully, eventually understanding will lead to treatment. And, finally, perhaps treatment will lead to reversal of the damage – and, hopefully, efforts will ultimately lead to a cure. In the meantime, however, TBI patients still have lives to lead. Mild chronic TBI inhibits short term memory and seriously impairs everyday function, which leads to problems both at work and at home. Regrettably, if the problem is sufficiently subtle TBI may not even be suspected; and the sufferer suffers even more. For those living with TBI the future can’t come soon enough.

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Resurrecting Lives offers help with TBI

Afghan war vets, St. Louis researchers
seek answers on head injuries

80% of Traumatic Brain Injury among the military occur during training.

Although TBI has been known as the cause of long term, disabling injury since the 1970’s, it is still poorly understood and is largely an invisible disability. Below are excerpts from an excellent article by Jesse Bogan of the St. Louis Post-Dispatch, on  efforts being made to understand, diagnose and treat TBI in the military setting. I would urge you to read the entire article – one of the best I’ve seen…

…Chrisanne Gordon, a physician in Ohio, said only 10 percent of healthcare providers in the country are familiar and actively treat mild TBI. Many who display symptoms don’t seek treatment anywhere.

“Thirteen years into the wars, we ought to know a little more,” said Gordon.

Gordon helped create the Resurrecting Lives Foundation, a group that advocates for better cooperation between the Veterans Administration, Department of Defense, and civilian health care systems so there will be better solutions for hundreds of thousands of veterans who suffer brain trauma, many without diagnosis.

Gordon is particularly adamant about the issue. A former TBI screener for the VA, she was questioned over her high diagnosis numbers. Also, she personally recovered from TBI after falling into a wall one Christmas while putting up decorations. She said it took more than a year to feel steady again. Her memory was never the same.

Yet her brain scan at the time of injury came back normal.

“That’s why I am so passionate about this,” she said, adding: “The brain totally affects ability to function in our fast-paced society.”

The men and women serving our country to protect our freedoms and those of our children deserve help in returning to normal lives when they leave the military. It’s the least we can do…

It’s a bigger problem than you think

Do you know the leading cause of death among young adults?

Brain-sloshing blows to the head are common on the field

Brave soldiers on the front face death and unimaginable challenges on a daily basis

Not gunshot wounds… Not automobile accidents… Not sports injuries… Not cancer… Not heart disease… Not war.

Perhaps surprisingly, Traumatic Brain Injury (TBI) is the leading cause of death among people between ages of 10 and 24. TBI is a major public health problem that affects all age groups. It occurs when a sudden trauma or head injury disrupts the function of the brain.

Researchers have discovered that even a small concussion can  have lasting consequences. And concern has been raised about the potential long-term effects of repeated concussion, particularly in those most at risk: young athletes and those engaged in professions associated with frequent head injury, including men and women in the military.

Current tests cannot reliably identify concussions, and there is no way to predict who will recover quickly, who will suffer long-term symptoms, and which few individuals will develop progressive brain degeneration, called chronic traumatic encephalopathy (CTE).

Studies have confirmed some alarming lasting effects, and organizations representing professional athletes are developing programs to help. The Veterans Administration (VA) has resources available for survivors of military action.

But there’s so much more to do…