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Traumatic brain injury: understanding TBI.

THE Defense and Veterans Brain Injury Center treats and researches traumatic brain injuries, the dominant wounds of Operation Iraqi Freedom.

Headquartered at Walter Reed Army Medical Center in Washington, D.C., the DVBIC operates nine sites across the country that treat patients suffering from mild, moderate and severe TBI; develop guidelines for care; study the prevalence of TBI; and conduct research to help future patients. DVBIC officials also frequently address the difference between TBI and Post Traumatic Stress Disorder.

"It's impossible not to be changed by war," said Dr. Deborah Warden, DVBIC's national director. And determining what behavior is stress related and what has to do with a previous concussion is difficult.

TBIs and PTSD share such common symptoms as difficulty concentrating, memory problems and irritability. TBI symptoms can also include headaches, dizziness and balance problems. A person suffering from PTSD may experience increasing anxiety, and may have frequent nightmares that often involve the reoccurrence of traumatic events.

Ms. Kathy Helmick, acting deputy director of Clinical and Educational Affairs at DVBIC, said diagnosis of a TBI is usually made when someone is first injured. But treatments for PTSD and TBI are the same. They include sleep, proper nutrition, and support from friends and loved ones.

Soldiers who have suffered a mild TBI must avoid a second head injury, Dr. Warden said, because, while the brain can recover from one mild TBI, two TBIs in quick succession have a cumulative effect that cannot be treated as easily with rest.

More than 35,000 servicemembers have been screened for TBIs. Roughly 11 percent of those screened had the symptoms of a mild TBI, while half had no symptoms.

According to a message the Army's Surgeon General sent to all Army commanders last July, mild TBI--also commonly referred to as a concussion--can affect operational effectiveness through poor marksmanship, delayed reaction time, decreased ability to concentrate, and inappropriate behavior that lasts for several days or longer.

To find Soldiers who may have sustained mild TBIs, the DVBIC created a questionnaire which asks Soldiers if they were injured while deployed in a combat theater and whether they have experienced any negative mental impact, Dr. Warden said.

A similar questionnaire and the Military Acute Concussion Evaluation, a standardized mental-status exam, are used to gauge the number of Soldiers who have suffered concussions. The military also plans to include TBI-screening questions as part of the post-deployment health-assessment process all servicemembers undergo.

A study proposed in Congress would follow servicemembers with mild, moderate and severe TBIs for 15 years, to determine the long-term effects of brain injuries. Researchers are also studying anxiety and hyperactivity medications, to determine if they can benefit TBI patients, said Dr. David Moore, DVBIC's director of research.

Ms. Karen Fleming-Michael is a public affairs officer for the U.S. Army Medical Materiel and Research Command.
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Author:Fleming-Michael, Karen
Publication:Soldiers Magazine
Geographic Code:1USA
Date:Sep 1, 2007
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