Traumatic Brain Injury (TBI) is a wound that was unheard of just a few short years ago. It occurs when a sudden trauma or head injury disrupts the function of the brain. Before modern-day medical advancements, speedy battlefield treatments, and advanced armor were developed, most people who suffered these types of injuries rarely survived.
Today however, TBI is becoming a more common injury among military members as well as the general public. Most reported military TBI cases are related to Improvised Explosive Devices, or IEDs.
Like professional sports teams, the military is beginning to understand that a TBI is more serious than a bump on the head that requires a couple of aspirin and back into action.
What is TBI?
Not all TBI injuries are totally debilitating, in fact concussions can be medically classified as a TBI.
What we normally think of when discussing TBI is a brain injury that is severe or traumatic enough to cause easily noticeable symptoms.
When the brain is injured, a person can experience a change in consciousness that can range from becoming disoriented and confused to slipping into a coma. The person might also have a loss of memory for the time immediately before or after the event that caused the injury.
See our Glossary of TBI-related terms for more information.
How Does TBI Happen?
Not all TBI injuries come from explosive blasts, TBIs can come from:
- The head being struck by an object, such as a bat or a fist during a fight
- The head striking an object, such as the dashboard in a car accident or the ground in a fall, or
- The head being affected by a nearby blast or explosion.
Symptoms can appear immediately or weeks to months following the injury. Depending upon the severity of the wound, TBI injuries fall into different categories:
Otherwise known as a concussion, mild TBI is more difficult to diagnose both in civilian life and on the military battlefield.
With mild TBI patients, full recovery can be within minutes to hours; a small percentage have symptoms that may persist months or years.
Symptoms of mild TBI include headache, dizziness, nausea & vomiting, trouble concentrating, memory problems and irritability.
This includes a population of patients that falls between the mild and severe spectrum. Moderate TBI patients have the most variability in their symptoms.
There is usually loss of consciousness, from an hour to a day; there can be confusion for days to weeks; and mental or physical deficits that can last months or be permanent.
This injury usually results from a significant closed head injury, as in an automobile accident or most open or penetrating injuries, where there may be considerable residual deficits of brain function.
Depending on the injury, a severe TBI could impact speech, sensory, vision and cognitive deficits including difficulties with attention, memory, concentration, and impulsiveness.
What are the Consequences of TBI?
TBI can cause a number of difficulties for the person who is injured. This can include physical changes, changes in behavior, or problems with thinking skills.
After an injury, a number of symptoms might be noted including headaches, dizziness/problems walking, fatigue, irritability, memory problems and problems paying attention.
These symptoms are often related to how severe the brain injury was at the time of injury, but there is much that is not understood, and this isn't always the case. Every person is different.
The military screens anyone suspected of a TBI while in theater. This screening is done on anyone:
- Who has been in a vehicle that was damaged by a blast
- Within 50 meters of a blast
- Within a structure hit by an explosive device
- Who sustained a direct blow to the head or experienced a loss of consciousness
- Who is directed to be screened by their command
While the VA automatically enters anyone into TBI treatment that has been diagnosed by the DOD, they also requires anyone who served in combat operations and separated from active duty service after Sep. 11, 2001 to complete a questionnaire to help identify anyone who may have TBI but wasn't diagnosed for it while in the military.
A positive screen doesn't necessarily diagnose TBI. It only indicates the need to further evaluate someone for a possible TBI. Veterans who screen positive with the TBI screening questionnaire are offered a comprehensive TBI evaluation with a specialist to determine whether they have a TBI or not
Depending on the situation, other specialists such as social workers, physical and occupational therapists, speech-language pathologists, psychologists, and others may be involved in the comprehensive evaluation to help determine whether treatment is necessary.
Care and Treatment
VA has a specialized system of care for TBI sufferers that integrates several types of care including medical, rehabilitative, and psychological care. VA also offers other benefits and treatment options such as family caregivers, specially adapted homes and more.
Treatments for TBI focus on the symptoms that cause most problems in everyday life. These can include:
- Learning strategies to deal with health, cognitive, and behavioral problems
- Rehabilitation therapies (such as physical therapy, occupational therapy, speech-language therapy)
- Assistive devices and technologies
For more details on VA's TBI care please visit our TBI Rehabilitation Page.
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