Soldiers fighting invisible enemy on home turf-TBI

Soldiers fighting invisible enemy on home turf
February 21st, 2011 @ 10:18pm
By Sarah Dallof
SALT LAKE CITY -- An alarming rise in a type of battlefield injury is prompting changes within the military and in how soldiers returning from battle are treated.

Symptoms closely mirror those of post-traumatic stress disorder. In fact, the two often operate in a vicious cycle.


Josh Hansen was injured in several blasts similar to these.

Doctors estimate up to 20 percent of soldiers currently deployed will suffer a traumatic brain injury -- something that just a few years ago was often never diagnosed or properly treated. Most will recover with no after affects, but some are changed forever.

When retired Army Sgt. Josh Hansen first saw a modern warfare video posted on YouTube by an insurgent group, it brought back painful memories -- it was one of his missions.

Hansen would suffer eight concussions during two tours of duty from blasts like those shown in the video.

"When we were first getting injured, no one thought of brain injuries. You just pop some aspirin and go back out and do your job," Hansen said.

Concussions occur when an outside force causes the brain to shake in the skull. It's an injury that routinely sidelines professional football and hockey players.

Hansen didn't notice slowdown until his fifth concussion. He says he would be in the middle of a mission when suddenly he had no idea how he'd gotten there.
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Soldiers fighting invisible enemy on home turf

National Guard study shows TBI symptoms more likely to be PTSD instead

For a long time you've been reminded that bomb blasts are a traumatic event. Well it looks like the "experts" finally agree and when they have been trying to put all the symptoms onto the TBI title, they were dealing with two different outcomes afterwards. About time!

Some TBI Symptoms More Likely to be PTSD
Week of January 17, 2011
A recent study which tracked National Guard Soldiers during the final month of their 16-month deployment to Iraq and then again a year after they returned home, found that servicemembers who suffer mild traumatic brain injuries in combat and then struggle with depression, irritability, alcohol abuse and similar problems are more likely to be experiencing post-traumatic stress than brain injury symptoms. An abstract of the study is available in the January 2011 edition of the Archives of General Psychiatry.

Study of Guard soldiers shows effects of mild brain injury not forever

Readers of this blog know I had TBI when I was very young and there was very little known about what happens to the brain after injury. I really should not have survived the fall but by the grace of God for some reason, I did. There are some things that will never be right about my brain, (stop thinking about jokes for now like my friends always come up with) but considering what my head went through, it's not all so bad. You can learn how to adapt. I had to see a speech therapist for a couple of years. Memory problems were overcome by learning some tricks like focusing on what I had to remember, writing down what was important and pretty much tossing things out once I was done with some useless information that really meant nothing. Unfortunately this meant that names were forgotten just about as soon as I was introduced to someone but their face was always remembered. This is a good report because it shows that while PTSD does not "go away" mild brain injury does and as far as traumatic brain injury, if my life is any indication, that can get better too.

Study of Guard soldiers shows effects of mild brain injury fade over time
by Jessica Mador, Minnesota Public Radio
January 4, 2011
St. Paul, Minn. — Results from an ongoing survey of Minnesota National Guard troops conducted by researchers at the Minneapolis VA Medical Center show that most cases of mild brain injury or concussion are likely to fade over time.

Researchers say the survey, which was published in the January issue of Archives of General Psychiatry, also sheds more light on post-traumatic stress symptoms.

The findings could be good news for the thousands of Iraqi and Afghanistan veterans believed to have suffered mild brain injury during combat, although it's unclear how many troops have come home with TBI.

Minneapolis VA Medical Center psychologist Melissa Polusny says the number of soldiers who report an injury that made them feel dazed or confused, or forced them to lose consciousness, varies widely.

Polusny and her colleagues surveyed more than 950 Guard soldiers, and in one survey, as many as 22 percent of them reported suffering a mild traumatic brain injury while deployed.

"When someone hears the word brain injury, I think they make assumptions about what that is," she said. "What we are talking about is concussion, which is sometimes referred to as mild traumatic brain injury."

Mild traumatic brain injury differs from moderate to severe TBI. Polusny says there are a number of common symptoms.

"Like headache, or difficulty concentrating, or irritability or memory difficulties, maybe ringing in the ears or tinitis," she said. "These are grouped together and referred to as post-oncussive symptoms."

The survey followed National Guard soldiers who served in Iraq in 2006 and 2007. Researchers were looking at the associations between concussion and PTSD symptoms, and whether mild TBI caused long-term effects.
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http://minnesota.publicradio.org/display/web/2011/01/04/brain-injury-study/

Head trauma from sports and war may be linked to ALS

Perhaps even Lou Gehrig had the related syndrome, but that will never be known because he was cremated. (AP File July 1939)

Multiple head injuries may spur ALS-type illness

“We believe that these three cases are the tip of the iceberg,’’ said neurosurgeon Robert Cantu, who is a codirector of the BU Center for the Study of Traumatic Encephalopathy. “We don’t know whether this is linked to the increased incidence of ALS in the military, who are subject to blasts and other head injuries, but we are concerned that it may be."

By Kay Lazar
Globe Staff

New research suggests that athletes who have had multiple head injuries, and possibly others such as military veterans exposed to repetitive brain traumas, may be prone to developing a disabling neurological disease similar to amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s disease.

A team of researchers from Boston University School of Medicine and the Veterans Administration Hospital in Bedford said yesterday they have pinpointed evidence of a new disease that mimics ALS in the brains of two former National Football League players previously thought to have died of ALS. They also found the new disease in the brain of a deceased professional boxer who was a military veteran.
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Multiple head injuries may spur ALS type illness

Veterans can have seizures decades after a head injury

Veterans can have seizures decades after a head injury, study finds
It's unclear what can trigger the post-traumatic epilepsy, which can hit up to 35 years after a penetrating head wound. The long-term study looks at Vietnam veterans.

By Jeannine Stein, Los Angeles Times

July 20, 2010


Soldiers who suffered brain injuries can develop seizures decades — as long as 35 years — after the initial injury, researchers have found.

A study published Tuesday in the journal Neurology found that among a group of 199 Vietnam veterans, about 13% developed post-traumatic epilepsy more than 14 years after they had suffered a penetrating head wound, such as a gunshot injury or shrapnel that entered brain tissue. Penetrating head injuries are generally linked with a higher risk for epilepsy than other types of head injuries, such as concussions.

Among the veterans, who are part of a long-term investigation called the Vietnam Head Injury Study, the overall rate of post-traumatic epilepsy was about 44%, consistent with similar military groups.

It is unclear what's responsible for the triggering of seizures so many years after a penetrating head injury, said study coauthor Jordan Grafman, chief of the Cognitive Neuroscience Section of the National Institute of Neurological Disorders and Stroke in Bethesda, Md.
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Veterans can have seizures decades after a head injury

Pentagon Issues New Policy For Diagnosing And Treating Brain Injuries

Pentagon Issues New Policy For Diagnosing And Treating Brain Injuries

by T. Christian Miller and Daniel Zwerdling


The Pentagon has issued a new directive ordering better tracking and treatment of mild traumatic brain injuries in war zones, including a mandatory 24-hour rest period for any soldier exposed to a nearby blast.

The new policy, which has been in development for months, also requires soldiers who have suffered three mild traumatic brain injuries, also known as concussions, to have a complete neurological assessment done before returning to the battlefield.

Military medical experts praised the new policy as an encouraging change in the Pentagon's approach.

The directive places the focus on evaluating all soldiers exposed to a blast or other head trauma, as opposed to relying upon medical staff or soldiers themselves to report symptoms from an injury.

"This relieves the burden of the soldier having to say, 'I'm hurt,'" said Stephen Xenakis, a retired brigadier general who advises the military on medical issues. "When you do that, it's like routine maintenance on a vehicle. It's understood that it's what you need to do responsibly to maintain optimal performance."
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New Policy For Diagnosing And Treating Brain Injuries
linked from Stars & Stripes

NPR finds military screens were missing tens of thousands TBI veterans

Senators Press Military To Improve Brain-Wound Care
Categories: Military

05:11 pm

June 23, 2010

by T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR


Senators pressed senior military leaders Tuesday to improve their efforts to address traumatic brain injuries, suicide and other wounds suffered by soldiers returning from the wars in Iraq and Afghanistan.

Responding to what he called "disconcerting" reports by NPR and ProPublica, Sen. Carl Levin, (D-Mich.) said at a hearing before the Senate Armed Services Committee that the military needed to better address the wide range of medical and behavioral problems affecting troops.

Earlier this month, we reported that the military was failing to diagnose and adequately treat troops with brain injuries. Since 2002, official military figures show more than 115,000 soldiers have suffered mild traumatic brain injuries, also called concussions, which leave no visible scars but can cause lasting problems with memory, concentration and other cognitive functions.

But the unpublished studies that we obtained and the experts that we talked to said that military screens were missing tens of thousands of additional cases. We also talked to soldiers at one of the military's largest bases who complained of trouble getting treatment.
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Senators Press Military To Improve Brain-Wound Care

Lt. Gen. Eric Schoomaker defends noncompliance on TBI tests calling it "no better than coin toss"

562,000 troops were tested once, before they left, but not after. Seems that the most important test would be for after deployment but this is the one not being done.

Military fails on brain-test follow-ups

By Gregg Zoroya - USA Today
Posted : Monday Jun 14, 2010 13:33:50 EDT

WASHINGTON — The Pentagon has failed to comply with a congressional directive to give all troops tests before and after they serve in combat to measure their thinking abilities and uncover possible brain injuries, military records show.

More than 562,000 tests of troops taken before they deployed have not been re-administered on their return by military health officials, the records show. That means the Pentagon could be missing thousands of cases of brain injury, says Rep. Bill Pascrell, D-N.J., who helped write the 2008 order.

"This is a total failure," says Pascrell, co-chairman of the bipartisan Congressional Brain Injury Task Force. "We're failing to find TBI (traumatic brain injury) and post-traumatic stress disorder in an era when the military is trying to find and assist folks who need it."

Lt. Gen. Eric Schoomaker, the Army surgeon general, and other Army officials say the test is flawed and no better than a "coin flip."
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Military fails on brain-test follow ups

Military Mental Health Probe Widens

Military Mental Health Probe Widens After NPR-ProPublica Report
06:36 pm
June 11, 2010


by T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR

Responding to an investigation by ProPublica and NPR, the chairman of the Senate Armed Services Committee said Friday that he would expand a hearing on soldier suicides to include a more extensive discussion of the military’s handling of traumatic brain injuries and post traumatic stress disorder.

"The recent NPR and ProPublica reports on the military's diagnosis, treatment, and tracking of traumatic brain injuries are concerning," Sen. Carl Levin, D-Mich., said in a prepared statement.

NPR and ProPublica reported this week that the military was failing to diagnose soldiers with so-called mild traumatic brain injuries. Such injuries, also called concussions, are typically difficult to detect but can cause lasting mental and physical difficulties.

Unpublished military studies and interviews with medical officials suggest there could be tens of thousands of soldiers suffering undiagnosed traumatic brain injuries, which have been called one of the wars' signature wounds. When soldiers were diagnosed, many received little or no treatment, even at large bases such as Fort Bliss in El Paso, Texas.

Soldiers with traumatic brain injury often also suffer from post traumatic stress disorder, or PTSD, a debilitating psychological wound. Those who survive roadside blasts can suffer both a brain injury and PTSD, which can be triggered by the terror of the event.

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Hyperbaric chamber clinical trial offers hope for TBI wounded

Hyperbaric chamber may treat TBI

By Amy McCullough - Staff writer
Posted : Wednesday Mar 31, 2010 7:47:00 EDT

The Defense Department hopes to find a better treatment for the 100,000 troops who have been diagnosed with mild Traumatic Brain Injury since 2003, and it’s looking at hyperbaric chambers — often used in cases of carbon monoxide poisoning — for the answer.

Although there have been studies looking at the impact these pressurized oxygen chambers have on TBI patients, none have been able to definitively answer whether hyperbaric oxygen can reduce or eliminate chronic symptoms of TBI such as headaches, memory loss and mood swings. A new clinical trial, which is expected to begin in January 2011, is designed to do just that.

The study, conducted by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, in Virginia, and the Army Research and Materiel Command, in Maryland, is expected to run for at least 18 months. It will include about 300 participants, mostly soldiers and Marines, and will build upon other ongoing studies on TBI treatment, said Col. Richard Ricciardi, director of the research evaluation and quality assurance and surveillance directorate at DCoE.
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http://www.armytimes.com/news/2010/03/army_TBI_033010w/

A Chance for Clues to Brain Injury in Combat Blasts

A Chance for Clues to Brain Injury in Combat Blasts
By ALAN SCHWARZ
Published: June 22, 2009
No direct impact caused Paul McQuigg’s brain injury in Iraq three years ago. And no wound from the incident visibly explains why Mr. McQuigg, now an office manager at a California Marine base, can get lost in his own neighborhood or arrive at the grocery store having forgotten why he left home.

But his blast injury — concussive brain trauma caused by an explosion’s invisible force waves — is no less real to him than a missing limb is to other veterans. Just how real could become clearer after he dies, when doctors slice up his brain to examine any damage.

Mr. McQuigg, 32, is one of 20 active and retired members of the military who recently agreed to donate their brain tissue upon death so that the effects of blast injuries — which, unlike most concussions, do not involve any direct contact with the head — can be better understood and treated.

The research will be conducted by the Sports Legacy Institute, a nonprofit organization based in Waltham, Mass., and by the Boston University Center for the Study of Traumatic Encephalopathy, whose recent examination of the brains of deceased football players has found damage linked to cognitive decline and depression.
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A Chance for Clues to Brain Injury in Combat Blasts

Report: Mild TBI linked to multiple ailments

Report: Mild TBI linked to multiple ailments

By Kelly Kennedy - Staff writer
Posted : Thursday Dec 4, 2008 13:47:28 EST

A review of about 2,000 studies reveals that service members with mild traumatic brain injuries — or concussions — are more susceptible to depression, aggression, memory problems, dizziness and irritability.

And according to the review by the Institute of Medicine of the National Academies, those who suffered a moderate or severe brain injury are more likely to have dementia, Parkinson’s disease, endocrine dysfunction, growth hormone insufficiency, long-term social function problems such as unemployment or diminished relationships, and premature death.

The researchers also found evidence suggesting connections between people with moderate or severe head injuries and diabetes, psychosis and neurocognitive issues; and between mild head injuries and seizures, visual deterioration, Alzheimer’s disease, Parkinson’s and post-traumatic stress disorder.

There also may be a link between decreased drug and alcohol use and traumatic brain injury, as well as suicides. The scientists said more research needs to be done in those areas.
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http://www.armytimes.com/news/2008/12/military_tbireport_120308w/

Shoot the Messenger - VA Tries to Fire Doctor-Turned-Whistleblower in Texas

"I had a chance to help 40,000 veterans with brain injury," Van Boven said. "I felt this was a gift and a blessing to help those who have served and suffered, and I am well trained to do it. ... I don't want these soldiers to become the next generation of homeless veterans."

Nov 1: Shoot the Messenger - VA Tries to Fire Doctor-Turned-Whistleblower in Texas

Laurel Chesky
Austin Chronicle (Texas)

Nov 01, 2008
October 31, 2008 - It all began with such promise. The Brain Imaging and Recovery Laboratory, launched in January, would hunt for treatments for what has become the Iraq war's signature ailment: traumatic brain injury. A program of the Central Texas Veterans Health Care System, part of the U.S. Department of Veterans Affairs, BIRL was housed at the University of Texas' J.J. Pickle Research Campus, where VA researchers had access to UT's $2.7 million brain scanner to help diagnose invisible head injuries.

But now, BIRL's research has ceased, and the program's director, neurologist Dr. Robert Van Boven, has been suspended from duty with pay since September, while the VA decides what to do with him. On Oct. 15, the VA held a closed hearing to determine whether or not to terminate Van Boven's employment. A board presiding over the hearing is expected to make a recommendation to Thomas Smith, the director of the Central Texas system, within a few weeks.

Van Boven is a compact, tightly wound man. Fast-talking and brimming with energy, he could serve as poster boy for the type A personality. His educational and professional feats match his tireless demeanor. Van Boven earned a doctorate in dental surgery from the University of Illinois and an M.D. from the University of Missouri. He completed two neurology residencies, at Harvard's Beth Israel Deaconess Medical Center and at Northwestern University. He has worked as a clinician at the National Institutes of Health and as an associate professor at Chicago Medical School and Louisiana State University.

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http://www.veteransforcommonsense.org/ArticleID/11541