Traumatic Brain Injury, Shell Shock, and Posttraumatic Stress Disorder in the Military—Past, Present, and Future

Almost every day, women and men of the US Armed Forces and allied coalition personnel experience strikes with high explosives while deployed at both Operation Iraqi Freedom and Operation Enduring Freedom. With the security of modern body armor and helmets, many army personnel who would have expired before from equal volatile vulnerability are in fact living, together with Traumatic Brain Injury.

Regrettably, multiple exposures to high explosives with following nonfatal brain injuries are now very common among service members, particularly with the present fact of repeated deployments.

Of combat-related TBIs, moderate Traumatic Brain Injury (mTBI), also called concussion, is the most typical form suffered by agency members at the moment. Defense and Veterans Brain Injury Center1 statistics demonstrate that, within the last ten years, there were 220 430 registered TBIs, with roughly 75% categorized as moderate Traumatic Brain Injury. Postdeployment polls indicate that 15% to 20 percent of service members returning from Operation Iraqi Freedom experienced 1 TBI. With recently enacted rules mandating the reporting and documentation of combat-related TBIs (Directive-Type Memorandum [DTM]-09-033), data now indicate an even higher proportion of support members in Operation Enduring Freedom have suffered or 2 TBIs, the amount of episodes sometimes reaching greater than 15 per individual.

In the military context, the Department of Veteran Affairs and the Department of Defense specify Traumatic Brain Injury as a”traumatically induced structural harm and/or physiological disruption of brain function as a consequence of an outside force,” signaled by 1 of the following clinical signs: decreased level of consciousness, loss of memory immediately prior to or following the accident, alteration in mental state, neurologic deficits, or intracranial lesion. The definition of moderate Traumatic Brain Injury comprises the particular parameters of reduction of consciousness significantly less than 30 minutes, alteration in mental condition fewer than 24 hours, and posttraumatic amnesia for under a day. The Glasgow Coma Scale ought to be nearly ordinary with scores between 13 and 15 over the initial 24 hours. To get mTBI, structural imaging such as computed tomography and magnetic resonance imaging must also be ordinary. However, though regular computed tomography and magnetic resonance imaging brain scans reveal no abnormalities, army personnel with mTBIs frequently suffer with chronic annoyance, sleep disturbance, memory and concentration difficulties, nausea, nausea, disequilibrium, vision change, or excessive tiredness,1 suggesting pathologic abnormalities on a microscopic amount.

Remarkably, there now exists a paucity of comprehensive neuropathology research to describe either the long-term or acute consequences of TBI on the brains of army employees. With insufficient neuropathology research on human cases, we do not know the nature and extent of harm to your brain driven by volatile blasts.

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