Mild Traumatic Brain Injury: A Signature Injury of the Iraq Conflict. Monica L. Jefferson, Ph.D. Neuropsychologist NJ WRIISC. LEARNING OBJECTIVES:. Review mental health concerns of returning Veterans Discuss current understandings of mild traumatic brain injury (MTBI)
Mild Traumatic Brain Injury: A Signature Injury of the Iraq Conflict
Monica L. Jefferson, Ph.D.
“A growing number of U.S. troops whose body armor helped them survive bomb and rocket attacks are suffering brain damage as a result of the blasts. It's a type of injury some military doctors say has become the signature woundof the Iraq war.”
(See National Center for PTSD http://www.ncptsd.va.gov/ncmain/index.jsp)
Post Traumatic Stress Disorder?
Mild Traumatic Brain Injury?
Traumatically induced physiologic disruption of brain
function as manifested by at least one of the following:
1. Any loss of consciousness
2. Any loss of memory for events immediately before or after the accident
3. Any alteration in mental state at the time of the accident
4. Focal neurologic deficit(s) that may or may not be transient
Severity of the injury does not exceed:
Since 2001, ~ 320, 000 (19.5%) sustained a TBI
Primary results from impact of the overpressurization wave with body surfaces
Secondary results from flying debris and bomb fragments
Tertiary results form individual being thrown by the blast
Quaternary all other explosion related injuries, illness or diseases not due to above
From: When Things Go Boom: Blast Injuries By Robert Nixon,
EMT-P, and Charles Stewart, MD.fireEMS, May 1, 2004
Are blast related MTBIs different than other MTBIs?
Can we apply current models to blasts?
on human brain
(See Carroll et al. 2004 J Rehabil Med)
(See Moser et al. 2007 Archives of Clin Neuropsych)
Initial Days or Weeks
e.g., Headache; Dizziness; Balance difficulties; Fatigue; Light/Noise sensitivity
e.g., Slowed information processing; Difficulties with attention/concentration
and/or Short-term memory
e.g., Irritability; Depressed mood; Anxiety; Mood lability
Initial Days or Weeks
NORMAL RECOVERY PROCESS
One to Six Months…and beyond
(e.g., Belanger et al., 2005; Binder et al.,1997; Schrelten & Shapiro, 2003)
MTBI: Civilians and Athletes
…But some do not fully recover
RISK FACTORS FOR POORER RECOVERY
MTBI and Returning Veterans
Can we apply our current knowledge?
Factors to consider with returning Veterans
…unique to our returning Veterans