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As a former “army brat” with a brother actively serving in the armed forces, certain topics that effect our troups remain close to my heart.  One topic in particular that has been an ever present concern for our armed forces is traumatic brain injuries (TBIs).  Blast injuries are the most common cause for war injuries which can result in either penetrating or closed brain injuries.  A penetrating injury is much easier to diagnose because of the outward appearance of a head injury, but closed injuries occur more often and are not as readily identified.

The Centers for Disease Control (CDC) states that a TBI is “caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”  The incidence of TBIs was reported to be elevated during the Iraq and Afganistan wars possibly as a result of decreased death rates for perviously fatal injuries due to improved armor, improved understanding and identification of closed brain injuries, and an increased frequency of explosive attacks.  These injuries can range from mild to severe.  Severe brain injuries often result in long term cognitive and physical disabilities.  Recovery occurs through various stages of physical and mental ability and is often assisted by neuro-based physical therapists.  Mild TBIs, which are the most common in the military, are more frequently referred to as concussions.  An improved understanding of these mild TBIs has occurred as a result of sport related research on concussions.

The following chart lists out the most common signs of a TBI according to the Defense and Veterans Brain Injury Center (DVBIC):

Physical

Cognitive

Emotional

  • Headache
  • Sleep disturbance
  • Dizziness
  • Balance problems
  • Nausea/vomiting
  • Fatigue
  • Visual disturbances
  • Sensitivity to light
  • Ringing in the ears

 

  • Concentration problems
  • Temporary gaps in memory
  • Attention problems
  • Slowed thinking
  • Difficulty finding words

 

  • Irritability
  • Anxiety
  • Depression
  • Mood swings

 

In addition to these symptoms following a blast injury, a soldier may present with symtoms of flashbacks or other re-experiencing phenomenon associated with post traumatic stress disorder (PTSD).  PTSD has been found to be more prominent in soldiers who have experienced mild TBIs versus severe TBIs and longer periods of unconsciousness.

In a battle zone, a soldier may be subject to multiple blasts and is, therefore, likely to sustain multiple concussions.  Several football related studies have been performed specifically in order to research the effects of mutliple concussions.  The most common result of these studies is a slower recovery time following each successive concussive episode.  These studies have also found that those who have sustained a mild TBI are at a greater risk of experiencing a second or third or multiple more TBIs, which is why prevention and awareness of post concussive guidelines are so important.  Some recovery tips based on post concussive guidelines include:

  • Drinking plenty of water
  • Eating healthy
  • Resting during the day and not mentally or physically overexerting yourself
  • Getting plenty of sleep
  • Avoiding smoking or drinking alcohol
  • Avoiding any non-prescribed medications
  • Avoiding caffeine or energy drinks/products
  • Avoiding situations that could cause another concussion
  • Staying in contact with your family and medical provider
  • Contacting a medical provider if symptoms persist or worsen

Physical therapists, especially those with sport or vestibular training, are equiped to assist recovery following concussions regardless of the cause (sport, blast, fall, etc.).  Although mild TBIs are more prevelent in the military population, anyone could sustain an injury that results in a concussion.  If you feel that you may have been experiencing post-concussive symptoms, please contact your physical therapist for an assessment.

If you have any questions on this topic or any others in which you are interested, feel free to leave any questions, comments, or suggestions. Thank you for reading and stay active.

Resources:

http://galvin-group.com/media/22741/tbi204.pdf

http://www.dvbic.org/tbi-basics

http://www.military.com/benefits/veterans-health-care/traumatic-brain-injury-overview.html

http://www.cdc.gov/traumaticbraininjury/

http://jama.jamanetwork.com/article.aspx?articleid=197667

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Disclaimer:  The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.