Army Finds Traumatic Brain Injuries In Up To 20% Of Combat Troops

A U.S. Army medical task force studying traumatic brain injuries in U.S. combat troops concluded that up to 20% of those who fought in Iraq or Afghanistan returned home with some degree of traumatic brain injury (TBI).

TBI is classified as mild, moderate, severe or penetrating, depending on the nature and severity of the injury. Mild TBI, commonly known as a concussion, was found to affect 10-20% of U.S. troops redeploying from combat in Iraq or Afghanistan.

Since the wars began, thousands of Soldiers and Marines have been treated for TBI. The most common cause was blast from an explosion.

Symptoms can include headache, dizziness, nausea, and light-sensitivity. Some of the symptoms seen in mild TBI, such as sleep disorders, memory problems, confusion and irritability, are also seen in Post-Traumatic Stress Disorder, making accurate diagnosis a challenge.

Less than half who suffered a mild TBI in combat have persistent symptoms associated with it, Col. Robert Labutta, a neurosurgeon with the Army surgeon general’s office, told AP.

In some cases, symptoms from the injury, such as irritability, affect a soldier’s interaction with his or her family and fellow soldiers, said Col. Jonathan Jaffin, deputy commander of the U.S. Army Medical Research and Materiel Command. “By identifying them, giving them a diagnosis, so they don’t think they’re just going crazy”¦.we think that helps them deal with it,” Col. Jaffin told AP.

The task force was created by the Army surgeon general and chaired by Brig. Gen. Donald Bradshaw, commander of the Army’s Southeast Regional Medical Command. The team included representatives from all the military services and the Department of Veterans Affairs (DVA). Bradshaw’s team studied the issue from January to May of last year, reviewing documents, visiting military and civilian facilities caring for injured service members, and interviewing soldiers, family members, caregivers and various subject matter experts.

“We wanted to bring together the best practices, policies and resources to treat and manage Soldiers and Marines diagnosed with TBI,” said Brig. Gen. Donald Bradshaw, in a press release by the Army’s Medical Department. "We also want to identify any gaps in their medical care as they reintegrate back to their civilian lives or continue their military careers. Furthermore, we wanted to make recommendations for areas of additional research. The task force completed its work in May 2007 and since that time DoD and DVA have made vast improvements in the identification, treatment, screening and education for TBI as well as establishing research processes and priorities. The task force findings are one contribution to this ongoing improvement in care."

The report identified some of the military’s TBI “best practices” facilities, including Fort Carson, CO and Walter Reed Army Medical Center.

"Fort Carson, Colo., Soldier Readiness Processing is a model that is being emulated across the Army. All redeploying Soldiers are surveyed by a health-care provider for symptoms of possible mild TBI. Fort Carson providers noted that survey responses indicate approximately 17 percent of redeploying Soldiers could have TBI. Their careful screening methods and prompt, multi-disciplinary treatment are a "best practice" of early and appropriate treatment," Brig. Gen. Bradshaw said.

"Walter Reed Army Medical Center had a 100 percent screening of all patients from theater (now all military treatment facilities and the DVA do the same) and a multi-disciplinary approach to treatment and education of patients and families," he added.

Brig. Gen. Bradshaw said he wants soldiers and their families to know that traumatic brain injury is a treatable condition with marked improvement in most cases””especially in concussion””and that Army leadership is proactively addressing the issue.

"We are committed to continued research in this area to help us more clearly understand the medical impacts of the war and the best ways to prevent, recognize and treat Soldiers with TBI," he said.

Currently, all troops brought to military medical facilities from a war zone are screened for TBI, said Brig. Gen. Bradshaw.

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On the Net:

Army Medicine: http://www.armymedicine.army.mil

Defense and Brain Injury Center: http://www.dvbic.org/

The report can be viewed at http://www.armymedicine.army.mil/news/reports/TBITaskForceReportJanuary2008.pdf