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travels can also play a role: In an open space, the damage to nearby humans may be less than if the blast wave ricochets off walls or other large obstacles, flinging the delicate brain in several directions before it subsides. All this violent activity can shear off or kill neural structures (and damage other internal organs), as well as cause brain bleeding and swelling. This can leave the victim with mild to severe brain damage and with
a life that may be horribly and irreversibly altered.
Concussive impact is being called modern warfare’s growing threat. And right now, it’s impossible to defend against.
A Disquieting Trend
Head wounds and brain injuries have always been a part of war. Floyd “Shad” Meshad, psychiatric social worker, traumatologist, and president and founder of the National Veterans Foundation, sustained a mild TBI in a helicopter crash in Vietnam. “There were a lot of head wounds in Vietnam,” he says. “Most of the GIs took off their helmets and flak jackets. It was 120 degrees and 100 percent humidity. And we didn’t wear our helmets much in combat.”
It’s impossible to know how many soldiers in Vietnam and earlier wars sustained traumatic brain injuries, although it’s been estimated that 20 percent of survivors did. In the current war, that percentage appears to be higher.
Beginning in January 2003, Walter Reed Army Medical Center in Washington, D.C., began studying a “a very select group of patients injured by a mechanism known to be high-risk for TBI,” says Dr. Warren Lux, neurologist at the Defense and Veterans Brain Injury Center (DVBIC), headquartered at Walter Reed. He says that among these warfighters with severe injuries from a blast, motor vehicle accident, fall, or gunshot wound to the head, face, or neck, 50 to 60 percent sustained a TBI, with a little more than half of those being moderate to severe. (See “What TBI Does,” below.) When that select group is counted within the 1,116 patients treated there for all battle injuries through April 2005, the percentage with TBI is 31 percent. It’s also possible, he says, that a few more had mild TBI that went unscreened.
Is this percentage really higher than in earlier wars? Lux cautions that no one really knows yet if that is true. Brain injury “has gotten more attention in this war,” he says. Articles about brain-injured soldiers have appeared in publications from the New England Journal of Medicine to People to local newspapers. Additionally, general advances in clinical neuroscience might mean that “our case identification [of TBI] is better,” explains Lux. “We may be counting them better in this conflict.”
a life that may be horribly and irreversibly altered.
Concussive impact is being called modern warfare’s growing threat. And right now, it’s impossible to defend against.
A Disquieting Trend
Head wounds and brain injuries have always been a part of war. Floyd “Shad” Meshad, psychiatric social worker, traumatologist, and president and founder of the National Veterans Foundation, sustained a mild TBI in a helicopter crash in Vietnam. “There were a lot of head wounds in Vietnam,” he says. “Most of the GIs took off their helmets and flak jackets. It was 120 degrees and 100 percent humidity. And we didn’t wear our helmets much in combat.”
It’s impossible to know how many soldiers in Vietnam and earlier wars sustained traumatic brain injuries, although it’s been estimated that 20 percent of survivors did. In the current war, that percentage appears to be higher.
Beginning in January 2003, Walter Reed Army Medical Center in Washington, D.C., began studying a “a very select group of patients injured by a mechanism known to be high-
Is this percentage really higher than in earlier wars? Lux cautions that no one really knows yet if that is true. Brain injury “has gotten more attention in this war,” he says. Articles about brain-
