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in clinical neuroscience might mean that “our case identification [of TBI] is better,” explains Lux. “We may be counting them better in this conflict.”
What might be further reasons for a higher percentage?
One, of course, is the large number of blasts occurring in close proximity to so many warfighters—far higher numbers than in any conflict in which U.S. military personnel have been involved to date.
And the other consists of several improvements that add up to one bittersweet fact: U.S. military personnel are surviving grievous wounds, even multiple traumatic amputations and severe brain injuries, that would have killed them before. They may survive, but they may never again be who they were, physically, emotionally, or mentally.
Those improvements include:
• Body armor that protects vital organs and Kevlar helmets that reduce penetrating brain injury (although their weight can add to injuries and they don’t protect against blast waves.).
• Extraordinary medical care at the front. “Trauma care has gotten much better,” says Lux, “as has acute resuscitative care. And people are getting care very early after injury in remarkably sophisticated surgeries.”
• Improved med-evac systems, with seriously injured soldiers being airlifted to Landstuhl, Germany, or Walter Reed in “relatively short times with good monitoring,” according to Lux.
The Trauma of Brain Injuries
Traumatic brain injury is often called “the secret epidemic,” says Rep. Bill Pascrell (D-NJ), co-chair of the Congressional Brain Injury Task Force. “We don’t know how many people are affected every year, civilian and military. Many people live through a brain injury only to be damaged.”
That damage can range from mildly irritating to devastating; it can be temporary or permanent. Depending on the severity or location of the injury, the person may face lifelong physical, emotional, or cognitive disabilities. The personality can be altered for the worse, as can the body. The ability to work or maintain relationships or care for oneself can be reduced or destroyed. Abuse of alcohol and drugs is common among TBI survivors. (Ironically, says Meshad, some TBI survivors “may look drunk, but it’s the brain injury.”) A TBI can devastate the survivor’s family; they have a divorce rate above 75 percent and high bankruptcy rate.
Another nickname for TBI is the “silent injury.” It often can go undiagnosed, particularly if it’s mild. The person can appear normal but cognitive functions can be subtly disabled so as to create problems with concentration, decision-making, reasoning, memory, and emotional control. This can create perplexing difficulties that may appear to have no cause, especially if the symptoms don’t appear soon after a head injury. Anyone with an undiagnosed TBI is at heightened risk, but a soldier in a combat zone especially so, perhaps appearing fit for duty but unable to function reliably. This fact has not gone unnoticed by the military doctors.
Ronald J. Glasser, M.D., has investigated and written about medicine in wartime since Vietnam. In an article in the June 2005 Harper’s Magazine, he wrote, “Army neurologists fear that severe brain injuries are being underdiagnosed, that more subtle neurological problems are being missed in soldiers not injured enough to enter the evac chain but who have been exposed to the types of concussive injuries prevalent in today’s form of urban warfare.”
Adding to the danger, not much is known about concussive brain injuries. According to Lux, one speculation is that the brain might also be injured simply by a blast wave itself, which may somehow penetrate invisibly and cause damage at deep levels within this organ that controls everything that makes us who we are. And in an environment like Iraq today, where exposure to multiple blasts is common, it’s likely that many soldiers could sustain more than one TBI. This is called “second impact syndrome.” Lux says it’s exceedingly rare in most populations, but it could be more common in Iraq.
In July, DoD announced that it planned to screen all troops returning from Iraq and Afghanistan for post-traumatic stress disorder and combat-related health problems within three to six months of returning home. While Glasser believes this is a positive development, he says, “There’s no one I’ve talked to that doesn’t believe (military personnel) need to be screened for brain injury before they go home.”
And given the proximity of so many warfighters to explosions in this war, he adds, “I think they should be checked if they’re near a roadside bomb.”
Meshad, who has years of experience working with brain-injured veterans, cautions that “the first three years home are critical. A lot of [TBI symptoms] are not obvious.” He says that families should keep an eye on veterans who
What might be further reasons for a higher percentage?
One, of course, is the large number of blasts occurring in close proximity to so many warfighters—far higher numbers than in any conflict in which U.S. military personnel have been involved to date.
And the other consists of several improvements that add up to one bittersweet fact: U.S. military personnel are surviving grievous wounds, even multiple traumatic amputations and severe brain injuries, that would have killed them before. They may survive, but they may never again be who they were, physically, emotionally, or mentally.
Those improvements include:
• Body armor that protects vital organs and Kevlar helmets that reduce penetrating brain injury (although their weight can add to injuries and they don’t protect against blast waves.).
• Extraordinary medical care at the front. “Trauma care has gotten much better,” says Lux, “as has acute resuscitative care. And people are getting care very early after injury in remarkably sophisticated surgeries.”
• Improved med-evac systems, with seriously injured soldiers being airlifted to Landstuhl, Germany, or Walter Reed in “relatively short times with good monitoring,” according to Lux.
The Trauma of Brain Injuries
Traumatic brain injury is often called “the secret epidemic,” says Rep. Bill Pascrell (D-NJ), co-chair of the Congressional Brain Injury Task Force. “We don’t know how many people are affected every year, civilian and military. Many people live through a brain injury only to be damaged.”
That damage can range from mildly irritating to devastating; it can be temporary or permanent. Depending on the severity or location of the injury, the person may face lifelong physical, emotional, or cognitive disabilities. The personality can be altered for the worse, as can the body. The ability to work or maintain relationships or care for oneself can be reduced or destroyed. Abuse of alcohol and drugs is common among TBI survivors. (Ironically, says Meshad, some TBI survivors “may look drunk, but it’s the brain injury.”) A TBI can devastate the survivor’s family; they have a divorce rate above 75 percent and high bankruptcy rate.
Another nickname for TBI is the “silent injury.” It often can go undiagnosed, particularly if it’s mild. The person can appear normal but cognitive functions can be subtly disabled so as to create problems with concentration, decision-making, reasoning, memory, and emotional control. This can create perplexing difficulties that may appear to have no cause, especially if the symptoms don’t appear soon after a head injury. Anyone with an undiagnosed TBI is at heightened risk, but a soldier in a combat zone especially so, perhaps appearing fit for duty but unable to function reliably. This fact has not gone unnoticed by the military doctors.
Ronald J. Glasser, M.D., has investigated and written about medicine in wartime since Vietnam. In an article in the June 2005 Harper’s Magazine, he wrote, “Army neurologists fear that severe brain injuries are being underdiagnosed, that more subtle neurological problems are being missed in soldiers not injured enough to enter the evac chain but who have been exposed to the types of concussive injuries prevalent in today’s form of urban warfare.”
Adding to the danger, not much is known about concussive brain injuries. According to Lux, one speculation is that the brain might also be injured simply by a blast wave itself, which may somehow penetrate invisibly and cause damage at deep levels within this organ that controls everything that makes us who we are. And in an environment like Iraq today, where exposure to multiple blasts is common, it’s likely that many soldiers could sustain more than one TBI. This is called “second impact syndrome.” Lux says it’s exceedingly rare in most populations, but it could be more common in Iraq.
In July, DoD announced that it planned to screen all troops returning from Iraq and Afghanistan for post-traumatic stress disorder and combat-related health problems within three to six months of returning home. While Glasser believes this is a positive development, he says, “There’s no one I’ve talked to that doesn’t believe (military personnel) need to be screened for brain injury before they go home.”
And given the proximity of so many warfighters to explosions in this war, he adds, “I think they should be checked if they’re near a roadside bomb.”
Meshad, who has years of experience working with brain-injured veterans, cautions that “the first three years home are critical. A lot of [TBI symptoms] are not obvious.” He says that families should keep an eye on veterans who
