November 5, 2007: It appears that at least six
percent of American Iraq and Afghanistan combat veterans have suffered TBI
(traumatic brain injury), to the extent that they may have long term problems.
Mild, and normally undetectable, cases of TBI are believed to be quite common
for combat veterans. Mild TBI is also known as a concussion, and is more common
because more troops are being exposed to roadside bombs. Most of these
explosions do not cause any obvious injuries to troops, even though their
vehicles may be damaged. Mild TBI has long been an area of research in sports
medicine. Veterans hospitals have many cases of World War II, Korea and Vietnam
vets eventually developing other problems because of long ago combat actions
that left them with mild TBI. Any kind of explosion can cause mild TBI, and
over a third of troops in combat get mild TBI. For most of them, there are no
long term consequences.
But as with football or hockey players who have
been knocked on the head one time too many, there is sometimes long term
damage. Until the 1980s, there was no hard evidence that mild TBI had long term
consequences. But research identified and verified that there were long term
effects in some victims. Before that, all that was known about the problem were
the many anecdotal stories about people "not being the same" after getting a
concussion.
Changes over time can indicate the onset of long
term problems with mild TBI. Troops departing for a combat zone, and returning,
are now being tested. Knowing that a solider has mild TBI makes it possible to
quickly treat any side effects, or conditions that will get worse over time.
The long term effects include damage to hearing, eyesight, sense of smell and
changes in personality. Improved diagnostic instruments and techniques are
constantly being developed, and perfected with use in civilian hospitals. Thus
the seeming explosion in TBI cases is only partially due to the widespread use
of roadside bombs. A lot of it is just being able to detect injuries that have
always been there as a result of combat, and were largely undetectable in the
past.
