March is Brain Injury Awareness Month, and it’s an opportune time to shine a light on this condition and also raise awareness about traumatic brain injuries in the military.

What Is a Brain Injury?

A traumatic brain injury (TBI) is a blow to the head that interrupts normal brain functions. There are several levels of TBI, ranging from mild to moderate to severe and penetrating. Victims are often temporarily unconscious and may “see stars.” Fortunately, not every blow to the head results in TBI. However, the statistics from the Brain Trauma Foundation are striking:

  • TBI is the leading cause of death and disability among children and adults between the ages of 1 to 44.
  • TBI causes approximately 52,000 deaths each year.
  • 5.3 million Americans (2 percent of the population) currently live with TBI-related disabilities.
  • Falls, motor vehicle crashes and events in which an individual is stuck by or against something are the leading causes of TBI.

TBI in the Military

In the military, rates of TBI are much higher, and this condition poses a significant health issue to service members and veterans. The Brain Trauma Foundation reports that:

  • 30 percent of veterans admitted to Walter Reed Army Medical Center have been diagnosed with a TBI.
  • Veterans’ advocates believe that between 10 percent and 20 percent of Iraq War veterans (150,000 and 300,000 service members) have some level of TBI.
  • Exposures to blasts are the leading cause of TBI among active duty military personnel in war zones.

While blasts may be the primary cause of TBI among deployed soldiers, they’re not the only one. The Defense and Veterans Brain Injury Center lists other leading causes that include bullets, fragments, falls, motor vehicle crashes and rollovers, sports and assaults.

Young military members are more likely to sustain a TBI, especially under the following circumstances:

  • They are actively performing military duties.
  • They have a prior history of concussions.
  • They have a prior history of substance abuse.

Severity Levels

According to Northeastern University, the severity levels of TBI are usually based on how long the individual was unconscious, the duration of post-traumatic amnesia (PTA) and the results of a brain scan.

Mild TBI is characterized by a loss of consciousness that usually lasts a few seconds or minutes, PTA for less than 1 hour of the TBI and normal brain imaging results.

Moderate TBI involves unconsciousness for 1 to 24 hours, PTA for 1 to 24 hours of the TBI and abnormal brain imaging results.

Severe TBI occurs when an individual has been unconscious or comatose for more than 24 hours, has PTA for more than 24 hours of the TBI and has abnormal brain imaging results. Also, the individual may be in a vegetative state, which means they are awake but not aware of their surroundings, or they may be in a minimally-responsive state in which the ability to interact and respond with the environment is intermittent.

Symptoms

The level of TBI determines the type of symptoms an individual may experience.

Mild TBI symptoms include:

  • Memory problems, being lost or confused, decreased attention and decreased concentration.
  • Irritability, depression and anxiety and emotional mood swings.
  • Headache, fatigue, sleep and visual disturbance, dizziness and balance problems.

Moderate and severe TBI symptoms include:

  • Decreased attention and concentration, decreased interaction skills and impulsiveness.
  • Apathy, depression, decreased lack of motivation and denial of difficulties.
  • Physical paralysis/weakness/spasticity; difficulty speaking and being understood; difficulties with temperature, movement, position and touch; partial or total vision loss; ringing in ears; and decreased bowel and bladder control.

Treatment and Recovery

After an individual physically recovers from TBI, tests may be performed to determine if rehabilitation is required. If so, usually someone from the patient’s hospital or a social worker will assist the individual in finding a program that can meet his or her specific needs. Brain injury rehabilitation can be provided in a hospital or clinical environment, or on an outpatient basis. Specific rehabilitation services vary depending on the type of injury, but some of the services include:

  • Cognitive therapy
  • Speech/language therapy
  • Physical therapy
  • Occupational therapy
  • Neurobehavioral therapy
  • Vocational rehabilitation
  • Neuropsychological testing

Alternative forms of therapy include:

  • Craniosacral therapy
  • Hyperbaric oxygen treatment
  • Biofield therapies
  • Meditation/mindfulness

Steps to Prevent TBIs

Awareness can also help prevent TBIs from occurring. In a deployed setting:

  • Wear a helmet and protective gear when in hazardous situations.
  • Wear safety belts when traveling in motor vehicles.
  • Before climbing up or descending buildings and structures, look for loose debris.
  • Use a buddy system when navigating heights or on certain missions.
  • Be aware of surroundings to avoid tripping accidents.
  • Inspect weapons before firing, and handle weapons properly.
  • Analyze the risk of ricocheting bullets before firing weapons.
  • Keep work environments free of foreign objects and debris.

Helping TBI Sufferers, Friends and Family Navigate Life with a TBI

In addition, service members and their families and caregivers are eligible for the Defense and Veterans Brain Injury Center TBI Recovery Support Program. And BrainLine.org also provides information about support groups and other advice for family members and caregivers of those with TBI. It is also important to raise awareness of TBI so the warning signs can be recognized and treatment can be sought for the affected individual.