Managing traumatic brain injury secondary to explosions

Burgess, Paula; Sullivent, Ernest E.; Sasser, Scott M.; Wald, Marlena M.; Ossmann, Eric W.; Kapil, Vikas

doi:10.4103/0974-2700.62120

Cited by 18 publications

(4 citation statements)

References 35 publications

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“… 11 The recovery pattern of combat mTBI associated with an explosion is that a greater fraction of individuals can have persisting post-concussion symptoms following mTBI; however, these individuals also have PTSD that is likely contributing to the persistence of symptoms. 12 The symptoms in the screen included alterations in cognition, behaviour, motor or sensory function, balance or coordination and the presence of pain including headache. During a 24-month period between 2006 and 2008, 2091 OIF/OEF veterans were screened with the four question TBI screening tool 10 and 385 screened positive (18.4%).…”

Section: Methodsmentioning

confidence: 99%

A case–control study examining whether neurological deficits and PTSD in combat veterans are related to episodes of mild TBI

et al. 2012

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BackgroundMild traumatic brain injury (mTBI) is a common injury among military personnel serving in Iraq or Afghanistan. The impact of repeated episodes of combat mTBI is unknown.ObjectiveTo evaluate relationships among mTBI, post-traumatic stress disorder (PTSD) and neurological deficits (NDs) in US veterans who served in Iraq or Afghanistan.MethodsThis was a case–control study. From 2091 veterans screened for traumatic brain injury, the authors studied 126 who sustained mTBI with one or more episodes of loss of consciousness (LOC) in combat. Comparison groups: 21 combat veterans who had definite or possible episodes of mTBI without LOC and 21 veterans who sustained mTBI with LOC as civilians.ResultsAmong combat veterans with mTBI, 52% had NDs, 66% had PTSD and 50% had PTSD and an ND. Impaired olfaction was the most common ND, found in 65 veterans. The prevalence of an ND or PTSD correlated with the number of mTBI exposures with LOC. The prevalence of an ND or PTSD was >90% for more than five episodes of LOC. Severity of PTSD and impairment of olfaction increased with number of LOC episodes. The prevalence of an ND for the 34 combat veterans with one episode of LOC (4/34=11.8%) was similar to that of the 21 veterans of similar age and educational background who sustained civilian mTBI with one episode of LOC (2/21=9.5%, p-NS).ConclusionsImpaired olfaction was the most frequently recognised ND. Repeated episodes of combat mTBI were associated with increased likelihood of PTSD and an ND. Combat setting may not increase the likelihood of an ND. Two possible connections between mTBI and PTSD are (1) that circumstances leading to combat mTBI likely involve severe psychological trauma and (2) that altered cerebral functioning following mTBI may increase the likelihood that a traumatic event results in PTSD.

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Section: Methodsmentioning

confidence: 99%

A case–control study examining whether neurological deficits and PTSD in combat veterans are related to episodes of mild TBI

et al. 2012

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“…Blast injury can occur directly from the blast energy or indirectly from events surrounding the blast and has differing terminology depending on the cause [25]. Primary BR-TBI occurs directly from exposure to blast pressure waves.…”

Section: Methodsmentioning

confidence: 99%

Visual function, traumatic brain injury, and posttraumatic stress disorder

et al. 2014

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Abstract-Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are signature injuries of the Iraq and Afghanistan conflicts. The conditions can be comorbid and have overlapping signs and symptoms, making it difficult to diagnose and treat each. TBI is associated with numerous changes in vision function, but vision problems secondary to PTSD have not been documented. To address this shortcoming, we reviewed the medical records of 100 patients with a history of TBI, noting PTSD diagnoses, visual symptoms, vision function abnormalities, and medications with visual side effects. Forty-one patients had PTSD and 59 did not. High rates of binocular vision and oculomotor function deficits were measured in patients with a history of TBI, but no significant differences between patients with or without PTSD were evident. However, compared to patients without PTSD, patients with PTSD had more self-reported visual symptoms in all four assessments and the complaint rates were significantly higher for light sensitivity and reading problems. Together, these findings may be beneficial in understanding vision problems in patients with TBI and PTSD as comorbid conditions compared with those with TBI alone.

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“…Although this chapter focused on models that primarily exist in the military and veteran sector, it is important to note that what has been identified is transferable to civilian settings. Terrorist attacks directed against civilian populations remain a significant threat in the United States, yet the civilian medical community has limited training and experience in the diagnosis and treatment of blast-related injuries (Burgess et al, 2010). In such instances, the injuries sustained by civilian survivors share many characteristics found in military polytrauma.…”

Section: Implications For the Fieldmentioning

confidence: 99%