Traumatic Brain Injury (TBI) is a disruption of brain function resulting from a blow or jolt to the head or penetrating head injury. A closed head injury occurs when the brain is not exposed, also called non-penetrating or blunt injury. A penetrating head injury, or open head injury, occurs when an object pierces the skull and breaches the dura mater, the outermost membrane of surrounding the brain.
More than 19,000 service members were diagnosed with mild traumatic brain injury, or concussion, in 2010, according to the Defense Centers of Excellence website. The signature injury of the war in Iraq and Afghanistan is residuals of TBI. The increase is linked to the common use of roadside improvised explosive devices or IEDs, and the resulting blasts. The VA has made brain injuries a leadership priority. They recognize the critical challenge of TBI and concussion as signature injuries of modern combat and one of the leading combat injury. [American Forces Press Service, March 14, 2011] Studies have estimated that about 20% of soldiers returning from Iraq and Afghanistan have suffered at least a mild traumatic brain injury while deployed. Of those, anywhere between 5% to nearly 50% may suffer both posttraumatic stress disorder and lingering problems from traumatic brain injuries. [ProPublica, and Daniel Zwerdling, NPR March 13, 2012]
Common causes of TBI or concussion on the battlefield include blasts, vehicle collisions, or blows to the head. TBIs can also occur on the football field, boxing rings, playgrounds, car accidents, and even at home. There are four categories of TBI including mild, moderate, severe and penetrating. A mild TBI, which is also known as a concussion, is the most common form of TBI. Although most people recover from mild TBI, the outcome of mild-penetrating TBIs can range from complete recovery to permanent disability or death.
Scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, are studying the effects of TBIs on the brain and the brain’s response to injury. There is more than meets the eye following even a mild traumatic brain injury. Oftentimes, initial scans do not reveal any physical damage to the brain tissue. However, recent studies by NINDS have shown that there may be therapeutic modalities to decrease the brain damage of TBI if treatment is rendered within hours after the injury. A service member in the battlefield is not afforded immediate medical treatment. More often than not, a veteran may not seek treatment for TBI symptoms until discharge from service. This may be in part due to lack of comprehension about the signs and symptoms of TBI not only by the veteran but oftentimes the VA medical community.
Veterans may be entitled to benefits if they can prove that the injury occurred during service, and that they have a current disability linked to the injury. In my next post we will discuss in more detail how to identify the signs and symptoms of TBI, and how the VA evaluates TBI for compensation.