Symptom Reporting and Management of Chronic Post-Concussive Symptoms in Military Service Members and Veterans

Understanding Traumatic Brain Injuries in Military Personnel: Investigating the Dynamic Interplay of the Cerebrospinal Fluid and Brain During Blasts

“…While patients with mild TBI typically recover within a few months, others may experience persistent symptoms known as post-concussive syndrome (PCS), which encompasses various physical, cognitive, behavioral, and emotional symptoms following a TBI. These symptoms can include headaches, dizziness, fatigue, insomnia, anxiety, irritability, and loss of memory or concentration [4,5]. A significant number of veterans with blastrelated TBI report three or more PCS symptoms for up to three months after their injury occurs, and between 7.5% to 40% are affected by these chronic issues [2].…”

“…Military deployment to combat zones exposes service members to concussive blast hazards, such as improvised explosive devices (IEDs), suicide bombers, land mines, mortar rounds, and grenades. While TBIs sustained during deployments are significant, most recorded cases among military personnel occur outside these scenarios such as sports participation or vehicular accidents leading to falls [5]. Blast injuries are categorized into the following four mechanisms: primary, secondary, tertiary, and quaternary.…”

“…An initial blast wound arises from the mechanical, thermal, and electromagnetic forces that emanate from an explosive mechanism. This generates a high-pressure wavefront that compresses the nearby air and quickly gives rise to negative pressure [5,7]. These compressed waves of pressure have the ability to travel at great speeds through various tissue types such as those with differing densities including air-fluid or fluid-solid structures which are particularly susceptible [8].…”

“…Quaternary harm refers to all explosion-related wounds, diseases, or illnesses that cannot be attributed to previously mentioned mechanisms nor pre-existing medical conditions exacerbation. This encompasses burns, crush injuries, toxic inhalations, and cardiovascular complications, among others [5,8,9]. In addition to the four identified mechanisms of blast injury, there is a hypothesis that blast-related brain injuries can occur through various means.…”