Warrior Corner

Thursday, March 11, 2010

Warrior Corner

Brain Injury Awareness Month

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By Marcie Birk

U.S. Army Public Health Command, Provisional

Mild TBI symptoms variable, have multiple causes

March is Brain Injury Awareness Month. Concussion is the most common traumatic brain injury, according to the Centers for Disease Control and Prevention. The signs of concussion, clinically known as mild traumatic brain injury or mTBI, are variable and can be subtle. A person may have a loss of consciousness and amnesia, or may only feel like ‘‘you got your bell rung” or see stars and feel dazed with no other symptoms.

Because concussions can present in so many different ways, they are as difficult to detect on the battlefield as they are on the football field.

TBI occurs when a blow or jolt to the head or a penetrating head injury disrupts the function of the brain. Traumatic brain injuries are most commonly caused by falls, motor vehicle crashes, being struck by⁄against something, and assaults. Blasts are the leading cause of TBI for active-duty military personnel in war. The severity of a TBI may range from ‘‘mild” (in other words, a brief change in mental status or consciousness) to ‘‘severe” (an extended period of unconsciousness or amnesia after the injury).

The Defense and Veterans Brain Injury Center indicates that 33 percent of patients who needed medical evaluation for battle-related injuries at Walter Reed Army Medical Center in 2008 had traumatic brain injury. The percentage breakdown for the Army is as follows:

Mild, 89 percent

Moderate, 5 percent

Severe, 3 percent

Penetrating, 3 percent

Not all blows or jolts to the head result in a TBI. It is possible to be exposed to blast and have no injury. However, Soldiers who are exposed to blasts or any possible cause of concussion should seek care as soon as possible after the injury.

Early medical intervention is key to making an accurate diagnosis and initiating treatment. This is particularly important during military operations because multiple concussions within a short period, before the brain has had time to recover from the last injury, can cause more severe deterioration than might have occurred with a single injury.

If care is sought too long after the injury, the health-care provider must rely on the Soldier’s recall of the event to make the diagnosis of concussion. Then, it is even more difficult to determine if the symptoms the Soldier is experiencing are as a result of the concussion or another condition. Therefore, it is important to see a healthcare provider as soon as possible after the event.

The primary treatment for concussions includes protection from sustaining a second injury before the brain heals, education about what concussion is and what to expect during recovery, and reassurance.

For people diagnosed with a mild traumatic brain injury, the following general tips can aid in recovery:

Get lots of rest. Don’t rush back to daily activities such as work, training or vigorous sports activity, as these can make symptoms worse. Recovery from concussions can take several weeks.

Avoid doing anything that could cause another blow or jolt to the head.

Ask your health-care provider when it’s safe to drive a car, ride a bike or use heavy equipment, because your ability to react may be slower after a brain injury.

Take only the drugs your health-care provider has approved, and don’t drink alcohol until your doctor says it’s OK.

For more information about traumatic brain injury, visit these Web sites: