Unlike previous wars fought by the United States military, the chances of soldiers surviving a traumatic brain injury (TBI), whether penetrating or concussive, are much higher these days. According to the New England Journal of Medicine and Textbooks of Military Medicine, in the Vietnam War, mortality was around 75%. In Iraq and Afghanistan, Kevlar helmets and body armor have significantly reduced the chances of dying. While the soldiers survive, a tragic byproduct of an IED blast or shrapnel wound may be living with a brain injury that can be severe enough to alter the lives of those who were wounded.

It is estimated that between 19 and 22 percent of wounded veterans have suffered a traumatic brain injury in battle. During the Vietnam War, 12 to 14 percent of combat casualties had a brain injury. Due to the improved helmets, they are less likely to have penetrating injuries where the brain is actually punctured by foreign objects or skull fragments. What is more likely is that the concussion from the blast will cause a closed brain injury.

When there is an explosion, there is a sudden and intense increase in air pressure by air molecules heating up and accelerating. This is followed by a decrease in pressure which causes an intense wind. The shifts in pressure cause blast waves that are strong enough to knock down walls, flip and destroy vehicles and throw objects and particles with extreme force. Imagine what this does to the human brain. While external pressure might throw objects at the head of soldiers, internally embolisms can occur in blood vessels somewhere in the body and then travel to the brain. The result is an obstruction in blood flow to the brain. Between eight and 25 percent of those who are injured in this way will be killed.

When soldiers suffer serious brain injuries on the battlefield, they are treated immediately and then transported to a combat support hospital. They undergo brain imaging here by neurosurgeons. Neurosurgeons control the bleeding, remove foreign objects and perform a craniectomy to reduce pressure from swelling. They are then evaluated and, depending on their condition, transferred to one of eight hospitals in the US.

When wounded soldiers are returned to the U.S., one of the hospitals they may be taken to is Walter Reed. All soldiers who suffered a blast injury are evaluated for a TBI. Almost 60 percent of soldiers admitted to Walter Reed with blast type injuries between 2003 and 2005 suffered some kind of brain injury. The severity of the TBI is assessed based on post-traumatic amnesia and loss of consciousness:

· Mild TBI – loss of consciousness less than one hour; post-traumatic amnesia lasting less than 24 hours

· Moderate TBI – loss of consciousness between one and 24 hours; post-traumatic amnesia lasting one to seven days

· Severe TBI – loss of consciousness for more than 24 hours; post-traumatic amnesia for more than a week

In moderate and severe TBI, hemorrhaging or other bleeding and swelling may be evident.

One of the frustrating conditions of a TBI is that symptoms are difficult to detect since they may not show for a long time after the brain was injured. They may also be masked and misdiagnosed as something else. However, some of the symptoms found in returning soldiers include:

· Headaches

· Disturbances in memory

· Disturbances in language

· Disturbances in attention

· Disturbances in sleep patterns

· Light and noise sensitivity

· Mood changes

· Anxiety

· Depression

· Emotional outbursts

· Impulsiveness

· Inappropriate laughter

While the soldiers who are affected by TBI must struggle every day with these symptoms, many of them are married or must return to their families for care. Now they, too, must share in helping in the often slow progression to some semblance of normality. Coming to grips with what they have seen and been through after long tours of duty, many of these men and women – as well as their families and communities – may find out that they need help for post-traumatic stress disorder, and some will have the added burden of continued care for a TBI.

There will be doctors, therapists and a litany of different drugs to lessen some of the symptoms, but the fact is that some of these veterans will never get better. The Centers for Disease Control estimates that as many as 5.3 million Americans are living with a debilitating TBI. This number is increasing yearly as more soldiers are wounded and are unable to return to duty. They return to civilian life, but many may slip through the cracks as the symptoms of TBIs manifest themselves in different ways.



Written By: Patricia Woloch

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Neil Shaban inquired:



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A traumatic brain injury is potentially one the most devastating disabilities. It not only affects the person suffering from the injury but can turn whole families upside down.

The range and severity of problems arising from a brain injury will vary significantly from person to person because every person’s brain injury varies in the extent and location of the damage. Some of the affects of a brain injury are not immediately obvious and only become apparent as time progresses.

The following are pointers to look out for in a persons make-up if you feel they may be suffering from a brain injury after a nasty knock or have suffered a serious injury.

Cognitive changes

A brain injury can cause cognitive changes which affect the individuals ability to learn new things, to work and to be able to interact socially.

Lack of insight

Individuals with a brain injury can have great difficulty seeing and accepting changes to their thinking and behaviour. The individual may deny the effects of the injury and have unreasonable expectations about what they are able to do.

Memory problems

There may be problems in remembering people’s names, passing on messages, or recalling details read in a book or a newspaper. They may forget what they are doing from one session to the next. Memory problems may cause the individual great difficulties in learning new things.

Poor concentration

A very common outcome is an inability to concentrate and to become easily distracted from what they are doing. This is usually because they are having difficulty concentrating.

Slowed responses

An individual with a brain injury may now be slower to answer questions or to perform tasks and may have difficulty in keeping up in conversations. Their capacity to respond quickly in an emergency may also be diminished.

Problem-solving

Individuals with a brain injury might have difficulty solving problems and planning and organising things they have to do. They may encounter trouble with open-ended decision-making and complex tasks need to be broken down into a step-by-step fashion.

Irritability

Individuals may also have a very low tolerance for frustration and can become easily agitated and may lose their temper quickly.

Socially inappropriate behaviour

People with a brain injury may no longer know how to act or behave in in social situations. This can be incredibly difficult for families to understand and cope with, particularly as they may no longer recognise their loved ones and not understand there behaviour.

Communication

A wide range of social skills may be affected by an a traumatic brain injury including the ability to have conversations, to interpret and respond to social cues, to show interest in others, to use humour appropriately, and to regulate the volume and tone of voice.

Depression

Depression in an individual with brain injury is a very common emotional consequence that usually comes some time after the injury. Signs of depression include lack of motivation, loss of sexual drive, sleep disturbance and tearfulness.

Headaches

There are multiple sources of head and neck pain, both inside and outside the head. Headaches arising from a brain injury can be caused by a number of reasons.

Visual problems

Vision and visual functioning is often adversely affected by brain injury. Some of the more common visual systems problems include double vision, rapid eye movement and near-sightedness.

Hearing problems

Hearing problems can occur for a number of reasons, particularly when the inner ear and/or temporal lobes have been damaged.

A traumatic brain injury is often called the invisible disability. As there are frequently no outward physical signs of a disability, effects such as fatigue, lack of initiation, anger, mood swings and egocentricity may be seen simply as bad personality traits by others. It is easy to see why a traumatic brain injury can be such a devastating disability, especially when the disability is not obvious to others.

The Injury Lawyers are a professional personal injury lawyers that deal with all types of brain injury claims.



Written By: Paul Steven

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