Traumatic brain injury, or TBI, has been dubbed the signature injury for soldiers involved in the war on terror, due largely to the insurgent style of fighting using roadside bombs and mortars, combined with multiple tours of duty. As a result, thousands of families are struggling to cope with the after effects of TBI, which are long-term and often undiagnosed until many years after a solider returns home.
David McRaney is an Army captain who always thought of himself as a quick thinker. Today, he likens his brain to a dial up internet connection. McRaney has trouble finding the right words to use, loses his train of thought mid-sentence, and has trouble recalling information he just read. He was in Afghanistan two years ago as a reservist when a mortar shell landed on the bunker he shared with three civilian contractors. The explosion killed the civilians and left McRaney with a traumatic brain injury that makes it difficult to follow direction or process speech.
TBI is typically the result of head trauma, such as a blow to the head or a violent jolt. In these cases, the brain collides with the inside of the skull. TBI also happens when a bullet or shrapnel penetrates the skull. Detection of TBI is difficult, and many people are not diagnosed until years after the initial injury, seeking help only when the symptoms progress over time. After severe criticism, the military has recently begun to take TBI more seriously. Evaluation of injuries has been changed, and soldiers are taken out of action if they have head trauma.
Diagnosing and treating TBI quickly is extremely important, but something that the military, especially during the first few years of the war, found to be very difficult. Some injuries, like McRaney’s, are easy to diagnose. He had shrapnel in his skull, and CAT scans showed trauma to his brain. Many other cases of TBI go undiagnosed because soldiers don’t report the injury.
“There’s a battle mind,” said Dr. Inge Thomas, coordinator of the TBI Injury Program at the Atlanta Veterans Affairs Medical Center. “Instead of going and getting rest, they go back in. They don’t want to be seen as sissies.”
While most people that who have mild TBI can fully recover with proper rest and medical management, many soldiers simply brush off the injury and go back into battle. In doing so, the injuries linger untreated, or worse, two or three head traumas happen over the course of a soldier’s career, which compounds the long-term side effects of TBI.
In February, a congressional report suggested that 15 to 23 percent of the two million soldiers who have served in Iraq and Afghanistan have experienced some form of TBI. That equates to between 300,000 and 460,000 cases in roughly ten years. Army experts disagree with those estimates, stating they have only diagnosed 126,000 cases of TBI in the decade since the wars began. Either way, the number is staggering and likely going to continue to grow.
As a consequence of the high number of traumatic brain injuries, the military has been forced to invest $633 million into over 200 research studies involving TBI. Some of the recent research, covered previously in our blog, has resulted in a blood test that can identify traumatic brain injury. Now the military is partnering with the NFL in an educational campaign aimed at reducing the stigma surrounding getting care for concussion and TBI.