Reports of soldiers incurring a traumatic brain injury (TBI or intracranial injury) have soared in numbers due to the United States' involvement in the Iraq and Afghanistan war.  The improved safety offered by kevlar helmets have saved soldier's lives, but the increased likelihood of survival has left some veterans with brain injuries that lead to lifelong disabilities.  

TBI's range in severity and type, and can either be classified as a penetrating TBI or a closed TBI.  Depending on the severity of the blow, the injury may be limited to a small, specific area of the brain, or encompass a vast majority area of the brain. 

The source of a soldier's brain injury is unlimited in scope, but there are obvious dangers which include: vehicle collisions, blunt force trauma, gunfire, falls, mortar explosions, or any other situation in which the soldier's head is exposed to trauma or sudden acceleration and/or deceleration. 

The increasing use of weaponry that produces explosions, blasts, and concussive force, are the obvious concerns for health officials who are studying disabled veterans with brain injuries.  Officials have noted that there has been a sharp increase in the number of veteran's who suffered a brain injury as a result of an indirect blast.  Again, the helmets are saving the lives of soldiers from flak and direct blasts, but it doesn't fully account for the concussive effects of an indirect blast. 

There are two common questions soldiers and veteran's often have with regard to brain injuries: What are the signs and symptoms of a TBI? and What type of treatment is available?    

If a TBI is not a penetrating injury, the signs and symptoms may not be initially visible or present.  A TBI or concussion may progress and worsen before being diagnosed. In some instances, more life-threatening injuries may be treated first and over-shadow the brain injury.  Also, some signs or symptoms may start small and be ignored until it is too late, and as a result, permanent injury and disability has occurred.   

Some of the signs or symptoms to watch for after sustaining a direct (or indirect blow) to the head include: hearing loss, headaches, seizures, dizziness, nausea, blurred vision, decreased strength or use of your limbs, and trouble concentrating or utilizing cognitive thought.  These symptoms are not all-inclusive, but are typical of most head injuries and need to be taken seriously. 

Veterans suffering from a brain injury are often left without a definitive cure. The brain does not heal or repair itself the way that skin can after a cut, or the way that bones can after a break.  Once the damage is done to a brain cell, it is permanent.  However, there is hope in the form of rehabilitation--the brain can "re-wire" itself in certain situations to "re-learn" processes. 

Rehabilitation can also teach the veteran how to adapt to specific life-altering changes that are a result of their TBI. In the vast majority of instances, veterans suffering from brain injuries are able to function at high levels despite their disability.  Rehabilitation is demanding and time-consuming, yet the sooner a disabled veteran receives treatment for their brain injury, the better their chances for an optimal recovery.   

James R. Keller
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