Traumatic Brain Injuries in the Military

Traumatic brain injury (TBI) is becoming a common wound of modern warfare. It has even been coined the “signature wound” of the War on Terror. While TBI is becoming more prevalent in wartime activity, many service men and women continue to go undiagnosed. Institutions, like the US Department of Veterans Affairs, are working to make quick and accurate diagnoses in order to prescribe appropriate and effective treatment.

TBI is caused by forced trauma to the head, either by being shaken or hit. The severity of a TBI varies from case to case, but symptoms range from mild concussions to a debilitating state. The majority of TBI’s acquired by military personnel are classified as mild traumatic brain injuries (MTBI). Initial symptoms of MTBI consist of loss of consciousness, disorientation, loss of memory, headache, and temporary loss of hearing and vision. They are often partnered with anxiety, irritability, difficulties processing information, limited concentration amongst other problems experienced down the road. While MTBI is most common amongst the men and women of the armed forces, more severe cases of TBI are happening much more frequently and often require the victim to attended specialty rehabilitative nursing centers, like CareMeridian.

The most common cause of a TBI in the military is due to blasts. There are three degrees of blast injuries where a TBI is common; Primary (due to blast itself), Secondary (due to objects being propelled by a blast) and Tertiary (due to a collision with a third party object). According to the Veterans Health Initiative, active male members of the military from the ages 18-24 are hospitalized with a TBI at a rate of 231 per 100,000 and females 150 per 100,000. Based on military force projections this would mean that 4,141 military personnel are hospitalized on average each year with a TBI, and these numbers often rise during wartimes.

The best prevention for veterans to avert the long-term effects of a brain injury is to recognize the symptoms of a TBI. Once the symptoms are identified an individual should take basic precautionary measures in order to begin the healing and recovery process until a more specific diagnosis can be made.

Service men and women give so much to protect this country and they deserve to come home to a happy and healthy life. Creating awareness about TBI will help ensure their long term health. By helping our veterans, their friends and their families recognize the early warning signs of a TBI, treatment can be sought as early as possible.

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Mild TBI

A traumatic brain injury (TBI) can be classified as mild if loss of consciousness and/or confusion and disorientation is shorter than 30 minutes. While MRI and CAT scans are often normal, the individual has cognitive problems such as headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration. These injuries are commonly overlooked.  Even though this type of TBI is called “mild”, the effect on the family and the injured person can be devastating.

Other Names For Mild TBI

• Concussion
• Minor head trauma
• Minor TBI
• Minor brain injury
• Minor head injury

Mild Traumatic Brain Injury is:

• Most prevalent TBI
• Often missed at time of initial injury
• 15% of people with mild TBI have symptoms that last one year or more.
• Defined as the result of the forceful motion of the head or impact causing a brief change in mental status (confusion, disorientation or loss of memory) or loss of consciousness for less than 30 minutes.
• Post injury symptoms are often referred to as post concussive syndrome.

Common Symptoms of Mild TBI

• Fatigue
• Headaches
• Visual disturbances
• Memory loss
• Poor attention/concentration
• Sleep disturbances
• Dizziness/loss of balance
• Irritability-emotional disturbances
• Feelings of depression
• Seizures

Other Symptoms Associated with Mild TBI

• Nausea
• Loss of smell
• Sensitivity to light and sounds
• Mood changes
• Getting lost or confused
• Slowness in thinking

These symptoms may not be present or noticed at the time of injury.  They may be delayed days or weeks before they appear.  The symptoms are often subtle and are often missed by the injured person, family and doctors.

The person looks normal and often moves normal in spite of not feeling or thinking normal.  This makes the diagnosis easy to miss.  Family and friends often notice changes in behavior before the injured person realizes there is a problem.  Frustration at work or when performing household tasks may bring the person to seek medical care.

Severe brain injury

The impact of a moderate to severe brain injury can include:

Cognitive deficits including difficulties with:

• Attention
• Concentration
• Distractibility
• Memory
• Speed of Processing
• Confusion
• Perseveration
• Impulsiveness
• Language Processing
• “Executive functions”

Speech and Language

• not understanding the spoken word (receptive aphasia)
• difficulty speaking and being understood (expressive aphasia)
• slurred speech
• speaking very fast or very slow
• problems reading
• problems writing

Sensory

• difficulties with interpretation of touch, temperature, movement, limb position and fine discrimination

Perceptual

• the integration or patterning of sensory impressions into psychologically meaningful data

Vision

• partial or total loss of vision
• weakness of eye muscles and double vision (diplopia)
• blurred vision
• problems judging distance
• involuntary eye movements (nystagmus)
• intolerance of light (photophobia)

Hearing

• decrease or loss of hearing
• ringing in the ears (tinnitus)
• increased sensitivity to sounds

Smell

• loss or diminished sense of smell (anosmia)

Taste

• loss or diminished sense of taste

Seizures

• the convulsions associated with epilepsy that can be several types and can involve disruption in  consciousness, sensory perception, or motor movements

Physical Changes

• Physical paralysis/spasticity
• Chronic pain
• Control of bowel and bladder
• Sleep disorders
• Loss of stamina
• Appetite changes
• Regulation of body temperature
• Menstrual difficulties

Social-Emotional

• Dependent behaviors
• Emotional ability
• Lack of motivation
• Irritability
• Aggression
• Depression
• Disinhibition
• Denial/lack of awareness

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Tags: military personnel, symptoms, TBI, traumatic brain injury, wartime