In The Field

AAN: The brain in combat

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I’ve heard it said that traumatic brain injury (TBI) is the ‘signature’ injury of the conflicts in Iraq and Afghanistan. Traumatic brain injury covers a spectrum of injuries that result from stresses, strains or deformations applied to the skull from the outside. The effects on memory are the most pronounced, but there can be other impacts on cognition. Some of these may only be short-lived, but there’s reason to believe that some persist after the injury looks to have cleared up.

One reason why more service members are returning from conflict with TBI is the increased use of IEDs, or improvised explosive devices, which create blasts that send out shockwaves when they go off. It’s the impact from these propagating shockwaves through the skull and into the brain that’s thought to cause the concussive effect of TBI.

Yesterday David Moore, at the Walter Reed Army Medical Center in Washington DC, presented results from brain scans of services members with TBI. His team have found that even 3 months after a blast injury, the brain still shows signs of inflammation. “That’s really of interest because it means you might be able to do something about it,” says Moore. “You might be able to give the service member an antiinflammatory and in some way break the cycle.” He points out, though, that antiinflammatory drugs might be a bad idea if patients have trauma that has led to bleeding – they could exacerbate these other injuries.

Longer term studies are planned; but many soldiers want to return to service and getting hold of them months or years after TBI can be tricky for researchers. “They’re dedicated soldiers,” says Moore.

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