mTBI & Concussions in the armed forces

Brave men and women of the armed forces put their life and health at risk in order to protect our freedom. Sometimes, veterans come back from combat zones with concussions. Some of these traumatic brain injuries involve major physical damage to the head that require immediate surgery, but other, more common concussions are referred to as mild traumatic brain injuries (mTBI).

These injuries can result from smaller impacts applied to the cranium, for instance when a patient from the Navy finds himself in the blast range of explosives or receives a small blow to the head.

mTBI can be caused by any impact on the head region, including impacts due to falling, hits as well as blasts and shattered pieces from explosions. These blows to the head can directly impact the functioning of neurons, the cells that allow our brain to function properly. For instance, physical damage to the neural networks where the injury occurred can temporarily or permanently affect sensory, motor or cognitive functions. The effect on the brain may also be indirect. For instance, some mTBI will result in inflammation of specific areas of the brain, which in turn adds pressure inside the cranium, resulting in improper functioning of brain networks located away from the injury. The symptoms of mTBI vary widely because of the various parts of the brain that can be affected, but some of the typical symptoms include

  • loss of consciousness
  • disorientation
  • dizziness
  • headaches
  • fatigue
  • brain fog, with poor concentration
  • altered sleep
  • anxiety and depression
  • loss of balance.[1]

Overall, 4.4% of soldiers are affected by mTBI, but this increases to 9.5% when considering the soldiers who are assigned a combat role.[2]

The medical name that was given to this type of injury is somewhat misleading. While the “mild” part of the name seeks to compare these injuries to other, more severe injuries, mTBI can be a debilitating injury that impairs people for many years, with enormous consequences on their ability to concentrate, work and enjoy life. Individuals coming back from combat in the Navy Army, Air Force, or other sections of the military with mTBI suffer from major medical problems that significantly affect their ability to recover a normal life.

The long term consequences of mTBI can be as severe as keeping them from being able to work for years and causing depression and anxiety disorders. Veterans coming back home with mTBI often face great difficulties in having their injury properly diagnosed and treated, and the hardship that results from their disability often compromises their recovery. What was originally a health issue can quickly cause economic and family issues, as individuals with mTBI are often left with little resources and mental energy to function properly in other spheres of their life. A report from the RAND corporation indicates that about one third of veterans come back with psychological problems, 64% of which are related to traumatic brain injury[3]. In some cases, mTBI can lead to severe depression and suicide.

Fortunately, recent advances in the treatment of mTBI now allow us to understand how dysfunctional brain networks can be repaired through neuroplasticity. Modern chiropractors such as Dr. Carlo Rinaudo in Sydney are now able to integrate concepts learned from neuroscience to develop specific brain-based therapies that allow correcting the symptoms of mTBI[4][5]. Specific techniques can be applied to correct any symptom of mTBI, including, for instance, vestibular rehabilitation, which helps brain networks recover functions related to equilibrium and balance.

Acting early in order to obtain treatment following an mTBI is the key to avoid letting this injury impact your life for too long.

References :
  1. Levine Z. (2010) Mild traumatic brain injury. Canadian Family Physician 56:658-662.
  2. Rona R.J., Jones M., Fear N.T., Hull L., Murphy D., Machell L., Coker B., Iversen A.C., Jones N., David A.S., Greenberg N., Hotopf M., Wessely S. (2012) Mild traumatic brain injury in UK military personnel returning from Afghanistan and Iraq: cohort and cross-sectional analyses. The Journal of Head Trauma Rehabilitation. 27:33-44.
  3. The RAND Corporation (2008) Invisible Wounds: Mental Health and Cognitive Care Needs of America’s Returning Veterans. Research Highlights.
  4. Buck P.W., Laster R.G., Sagrati J.S., Kirzner R.S. (2012) Working with mild traumatic brain injury: voices from the field. Rehabilitation Research and Practice 2012
  5. May G., Benson R., Balon R., Boutros N. (2013) Neurofeedback and traumatic brain injury: A literature review. Annals of Clinical Psychiatry 25:289-296.