Blast Injuries Among Returning Veterans

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The Defense and Veterans Brain Injury Center report that 59% of an “at risk” group of injured soldiers returning from Iraq and Afghanistan for treatment at Walter Reed Hospital in 2003-2004 suffered at least “a mild brain injury”. Of another group of 433 returning injured soldiers, at least half were identified as having moderate to severe brain injuries. In another group of 1303 soldiers with injury to the lower extremities, 51% had neurologic symptoms. This group included 36% with EEG abnormalities. As the group of 1303 injured individuals has been followed by VA physicians and neuropsychologists, 30% are demonstrating both neurological and EEG abnormalities into the “chronic stage”.

Blast injuries have been studied since World War I. The survival rates of the battlefield injured Iraq and Afghanistan soldiers are significantly higher than any of the past wars and are producing more individuals who will live with lifelong effects of brain injuries. We also are becoming aware of a group of soldiers who are having multiple concussive injuries from IED’s and are returning to the battlefield with little to no treatment.

Research into the area of blast injuries is growing as evidenced in an article: Blast-Related Traumatic Brain Injury: What is Known? (Taber, Warden and Hurley, J. of Neuropsychiatry 18:2, Spring 2006) in which the authors address the specific aspects of the brain trauma from these injuries and the implications for functional impairment.

Earlier this week, a CNN broadcast, identified that there is a growing number of soldiers returning to the battlefield with concussive injuries suffered via exposure to IED explosions. They reported individuals with multiple concussions returning to battle with little to no medical care or identification of their concussive injuries.

Unfortunately, this is group of individuals for whom the identification of their neurologic injury and resulting problems may be delayed. They may leave the armed forces and experience personality, behavior and cognitive problems years later. Who will know that the problems they are having relate to the multiple mild brain injuries which occurred while in the military? And, who will offer and support the needed treatment and rehabilitative services?

The toll for the injured soldiers surviving horrific injuries and living with life long disabilities is significant and incalculable. The toll for those with unidentified brain injuries is yet to be determined.

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