Frontline of assessing mild traumatic brain injury

Courtesy Photo | Improvised explosive device blasts remain one of the most terrifying experiences for Soldiers. Even those emerging with seemingly minor injuries could be at risk for what is being called the war's 'signature injury': Mild Traumatic Brain Injury. With the 316th Expeditionary Sustainment Command being the largest logistics command in theater, pushing the most supplies throughout Iraq usually by ground, mTBI will continue to be cause for concern.  

BALAD, IRAQ

12.06.2007

Courtesy Story

302nd Mobile Public Affairs Detachment

LOGISTICS SUPPORT AREA ANACONDA, Iraq - The sound is thunderous as the earth explodes, emitting fragments of shrapnel at high velocity. A firestorm erupts. Black smoke fills the vehicle.

The improvised explosive device is the main killer and most common threat facing Soldiers in Iraq. Recent implementation of better protective equipment and the latest in explosives-mitigating vehicles results in troops surviving blasts they might have died from in past wars.

Yet IED blasts remain one of the most terrifying experiences for Soldiers. Even those emerging with seemingly minor injuries could be at risk for what is being called the war's 'signature injury': Mild Traumatic Brain Injury, said Air Force Lt. Col. Barbara Severson-Olson, a licensed clinical social worker at the mental health clinic, and part of the 332nd Expeditionary Aerospace Medicine Squadron.

With the 316th Sustainment Command (Expeditionary) being the largest logistics command in theater, pushing the most supplies throughout Iraq usually by ground, mTBI will continue to be cause for concern.

Severson-Olson, Air Force Maj. Connie J. Johnmeyer, staff psychologist with the 332nd Expeditionary Medical Group, and Air Force Master Sgt. Gary Scott, a mental health service non-commissioned officer, also with the 332nd EAMDS, are on the frontline of assessing mTBI in service members. The more attacks on service members, the busier the clinic gets and it's not hurting for business.

According to the Defense and Veterans Brain Injury Center's May 2007 TBI Consensus Conference, TBI is a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force. It is indicated by new onset or worsening of at least one of the following clinical signs immediately following the event: any period of loss of or a decreased level of consciousness; any loss of memory for events immediately before or after the injury; any alteration in mental state at the time of the injury (e.g. confusion, disorientation, slowed thinking); neurological deficits (e.g. weakness, balance disturbance, praxis, paresis/plegia, change in vision, other sensory alterations that may or may not be transient); intracranial lesion mTBI is a less severe version of TBI.

"You know all those (public service announcements) that say 'don't shake your baby?' A soldier's brain is experiencing something similar to that during a blast. Your brain is sitting in this gel, fluid situation and the blast causes your brain to do this back and forth motion," said Johnmeyer, using her hands to gesture the motion the brain experiences. "Injury can result and it doesn't require unconsciousness to be mTBI," said Johnmeyer.

The team uses various assessment tools to determine if Soldiers are experiencing mTBI, including the Military Acute Concussion Evaluation and the Automated Neuro-psychological Assessment Metrics.

The goal of the team is to get service members suspected of having mTBI assessed and sent to the appropriate agency or facility. In some cases that means service members will be returned to their units with either no or some restrictions to duty, sent to specialists such as radiologists, ophthalmologists and audiologists here in theater, or if need be, sent to Landstuhl Regional Medical Center in Germany for further treatment. After evaluating the patient, the team compiles a report with recommendations for the referring physician.

When asked who is at risk, the team said Soldiers traveling in vehicles on IED- laden roads are at greatest risk, but anyone could be affected.

"If you're in uniform in Iraq, you're at risk," said Scott.

"Some of our patients are folks who were on foot patrols, others were just standing in their base and got mortared, but by in large our clients are folks that were injured while on the road," said Severson-Olson.

But the prognosis is not hopeless and a flurry of new research into TBI is presently being conducted. Some servicemembers experiencing mTBI can heal over time according to Johnmeyer.

"We have a young population. Most of our (patients) are in their early twenties. Brain tissue has some renewing value in these younger folks," said Johnmeyer. "Time can be the best treatment for some...Think of a sprained ankle. You need to give it time to heal, time for the swelling to reduce. After a week your ankle is better. This can happen to the brain too."

• Date Taken: 12.06.2007
• Date Posted: 12.06.2007 17:59
• Story ID: 14505
• Location: BALAD, IQ