Assessing Type of TBI in Military Personnel

Explosions are the most common cause of traumatic brain injuries (TBI) in veterans returning from Iraq and Afghanistan. A new study, which recently appeared in JAMA Neurology, shows that military personnel with mild brain trauma related to such blasts had outcomes similar to those with mild brain injury from other causes, according to researchers at Washington University School of Medicine in St. Louis. However, nearly 80 percent of patients in both categories of brain trauma suffered moderate to severe overall disability within a year after injury. About 20 percent of U.S. forces in Iraq and Afghanistan are estimated to have experienced a head injury during deployment. Of those injuries, about 83 percent are considered mild forms of TBI or concussion. The researchers examined 255 U.S. military personnel who were injured while on active duty in Iraq and Afghanistan. To assess long-term outcomes, the investigators were able to evaluate 178 patients six to 12 months later. Of these, 53 had mild traumatic brain injury (mTBI) involving an explosion and 29 had mTBI unrelated to a blast. As a comparison, the study also included 27 military personnel with blast exposure (meaning they felt the force of an explosion) but no brain injuries and 69 with no blast exposure who were evacuated for medical reasons other than brain injury. Comparing the two groups with TBI (blast- versus nonblast-related), the research team saw no difference in overall disability, with 77 percent of the blast group suffering moderate to severe disability, compared with 79 percent of the nonblast group. They also saw no differences between these groups in severity of headaches, depression, post-traumatic stress disorder (PTSD) and performance on cognitive tests. That was despite the fact that the blast-related group reported seeing significantly more active combat. To learn more about the study, click here.