Marine Corps Base Quantico -- Nearly 340,000 active-duty and veteran service members suffer from Traumatic Brain Injury (TBI), but the surprising fact is that most of those were not sustained in a combat setting.
“That’s a misconception,” Dr. Scott Livingston, director of education for Defense and Veterans Brain Injury Center (DVBIC), said. “The data suggest that more than 80 percent occur as a result of motor vehicle crashes, falls, and sports and recreation.”
Livingston is the government lead for DVBIC’s A Head for the Future initiative, a campaign that was launched in March 2015 to raise awareness of the causes and symptoms of TBI and ways it can be prevented. A series of video testimonials on the A Head for the Future website feature real-life service veterans who have volunteered to tell their stories of surviving TBI.
Within a combat setting, TBIs are often caused by the detonation of improvised explosive devices (IEDs), which were used extensively in the Iraq and Afghanistan wars.
“Most are caused by the movement of the brain inside the head as a result of blast pressure waves,” Livingston explained. Blast-related TBIs can also be caused by shrapnel hitting the service member or by the service member being thrown by the blast.
In garrison, service members often enjoy active and sometimes hazardous leisure activities such as motorcycling, mountain climbing, and skydiving, all of which carry a risk of TBI.
DVBIC has been tracking occurrences of TBI since 2000, Livingston said. TBIs have been described for thousands of years in military and sports settings but their significance has historically been downplayed.
“It used to just be known as ‘getting your bell rung’ or ‘getting dinged,’” Livingston said. “So, in a way that really minimizes the seriousness and makes it sound like it’s not a big deal.”
But TBIs have far-reaching physical, emotional and occupational effects. According to A Head for the Future, some of the immediate symptoms include headaches, visual problems, tinnitus, loss of consciousness, nausea, slurred speech, delayed response to questions and fatigue.
Additional symptoms can appear hours or even days later. These include trouble concentrating, memory loss, irritability or other personality changes, light and noise sensitivity, sleep problems, disorders of taste and smell, mood swings, depression and anxiety.
In its mildest—and most common—form, TBI was and still is known as “concussion.” Livingston said that most people who suffer a concussion will recover fully with little intervention other than cognitive and physical rest.
“Usually, symptoms resolve in seven to 10 days,” said Livingston.
The 20 percent of cases of mild TBI that don’t resolve in that time frame typically recover fully in several weeks or up to several months.
In contrast, moderate or severe brain injuries typically require months or years to recover, and complete recovery, although possible, doesn't always occur. These cases require hospitalization and outpatient treatment involving medications and occupational, physical and speech therapies.
Patients with these more severe cases will need the support of family-members. Livingston said that caring for a loved-one with a TBI is challenging but that support services are available to caregivers.
“If you’re a caregiver, I strongly recommend talking to your primary care provider who can put you in touch with peer support groups,” Livingston said. “Your patience and encouragement will absolutely pay off in the end.”
Whether the case is mild or severe, early recognition is the best treatment. People who think they may have a concussion should see their general practitioner right away or go to an emergency room.
The good news is that full recovery from TBI is possible, Livingston said. And prevention measures outside of the combat setting are straightforward.
“It’s really just simple common sense,” Livingston said. “Always wear a seat belt or a helmet. Always be thinking ahead to prevent injury before it happens.”
For more information, visit http://dvbic.dcoe.mil/aheadforthefuture.
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