May 1, 2007:
The widespread use of roadside bombs
and rocket propelled grenades in Iraq is causing more injuries than it appears.
As early as 2004, when army doctors checked out soldiers wounded in Iraq, they
found 62 percent also had undiagnosed concussion injuries. Later studies found
that 18 percent of all troops serving in Iraq suffered some damage from
roadside bombs and other explosions. In order to identify those troops who
might have injuries that show no symptoms now, but might turn into serious
problems years from now, the U.S. Army is using a new brain scanner combines
gamma rays and radioisotopes to identify subtle damage to the brain.
Normally, brain injuries (concussion) from the of
nearbyexplosions, appear to wear off
after a few hours, or days, of rest. What has been missed until now were the
long term effects. Too many concussions has long been known to cause permanent
and severe brain damage. Boxers who took too many blows to the head would, in
their later years, become permanently disoriented and mentally disabled. This
came to be called punch drunk. But as more professional football and hockey
players suffered concussions, experts in sports medicine began to notice
patterns in how a few concussions could cause serious, and delayed, long term
damage. Better diagnostic tools (like MRI) made it possible to see the damage
early on.
Progress in treating sports injuries, especially
head concussions, have provided the U.S. Army with a large body of experience
on how to spot, and treat concussions (from explosions) and the resulting brain
injuries. The army developed guidelines for combat commanders to apply for
troops who suffer concussions, giving them several days of rest, or sending
them for MRI and other tests to make sure there is no serious damage. Like
professional athletes, soldiers who have suffered a certain amount of
concussion injury will be removed from combat duty. This in itself is nothing
new. For decades, combat soldiers have been shifted to less strenuous jobs when
they suffered permanent muscular or skeletal injuries from combat, or even
peacetime, operations. Paratroopers, or even airmobile infantry who jump a few
feet out of helicopters with carrying a hundred pounds of gear, often suffer
permanent back or other injuries. Tank crews suffer similar risks jumping off
their tanks, or overexerting themselves pulling maintenance on their armored
behemoths. Just training for combat is a very physically demanding task.
Concussions, first encountered on a large scale
during World War I, which gave rise to the term "shell shock," was the result
of the increasing use of high explosive shells and hand grenades. This created
large numbers of soldiers with no visible wounds, but who were definitely in a
state of shock. Shell shock eventually came to be renamed combat fatigue,
because it wasn't the numerous blast injuries that caused so many soldiers to
go into a long term state of mental distress, but prolonged exposure to the
stresses of combat.
These long term injuries are nothing new, and with
thousands of World War II combat veterans studied for over half a century,
there is more and more data to pinpoint what kind of injuries we are dealing
with, and what their long term effects are. The big breakthrough has been the
ability to spot these subtle injuries early on.
