Brain injuries baffle war vets, doctors

[Barrett808]

Source: McClatchy

RALEIGH, N.C. - Marine Gunnery Sgt. Bill Rosborough recalls with excruciating clarity when a water truck smashed into the building where he was preparing an Iraqi Army payroll.

Explosives hidden inside the truck vaporized the wall of his office in Al Kasik, vaulting him into the air. Shards of glass cut him, and building parts crushed him.

Back at Camp LeJeune three years later, many of Rosborough's visible wounds have been patched. But his brain still isn't right.

''I was able to do a million things before. Now I walk in the grocery store and I can't remember why I went,'' said Rosborough, 36, who works in the Wounded Warrior Barracks at Camp LeJeune, where injured Marines stay before returning to duty or leaving the military.

The military, faced with relentless bomb attacks on U.S. forces, in its latest survey estimates that as many as one in five soldiers and Marines will suffer ''mild'' traumatic brain injuries in Iraq. Seventy percent are better by the time they return stateside, but for others, symptoms persist.

Read more: http://www.newspress.com/Top/Article/article.jsp?Section=NATIONAL&ID=565003467749720172

[SpiralHawk]

1. Diagnosis: This is clearly "Bush Brain Syndrome"

These fine soldiers are suffering brain injuries for eternity
because of the brainless antics of our lying Commander AWOL
and his corrupt cabal of war-profiteering republicon cronies.

[stillcool]

2. Doctors are baffled?

you've got to be shitting me!! WTF is a 'mild'-"traumatic" brain injury?

[gratuitous]

6. Causation probably isn't what's so baffling

But coming up with a standardized set of descriptions for each level of injury, listing deficits, proposed treatment and therapies, and getting to an "approved" list of how to go about diagnosing and treating is probably very baffling. How impaired does a person have to be to meet a threshold for treatment? What treatments are likely to work? And so on and so forth.

Unfortunately, while broken bones can be classified and treated in a predictable, uniform manner, traumatic brain injuries, particularly closed head brain injuries, don't readily yield to a uniform diagnostic procedure. And we'll have thousands of these folks walking around for 40 or 50 years, some of whom will seek treatment (and either get it or not get it) and some of whom will just plod along silently, figuring that it's just the normal aging process or that there's nothing that can be done for them. Still others will investigate treatment, but be scared off because they don't want to be labeled as "brain damaged."

A firm I used to work for represented an individual who had pretty much gone through all the administrative steps. He had an injury, deserved treatment and compensation, but nobody would authorize it. When we told him that our next step was to file a lawsuit, and that the government agency would be named as defendant, he gave up his claim because as a good American, he couldn't ever bring himself to sue his own government.

Heart-breaking only begins to describe it.

[stillcool]

8. I had a serious head injury...

due to a car accident, and was in a coma for a time. Aside from that I had some serious addictions, and an unusual childhood...my diagnosis has altered with each doctor I've see over the last fifteen years. My dad, was in WWII and suffered from what they then called 'shell-shock'. His preferred treatment method was a slow death due to alcoholism. After the Vietnam war, I seemed to encounter a slew of heroin addicts. Birds of a feather flocking together? There definitely should be readily available statistics on mental maladies/alcohol/drug abuse and veterans of combat duty. And, there also should be reams of information regarding cause and effect in terms of what happens to a person's psyche in a war zone. With all the drugs on the market...although no one seems to know exactly what they do...there should be no question..at all...that these soldiers obviously need a minimum of some kind of therapy to come to terms with their experience...wouldn't that be 'normal'?

[youngdem]

9. The kind where you appear normal but aren't

[0rganism]

10. definition of "mild traumatic brain injury"

one the pentagon can overlook when calculating a wounded soldier's disabled percentage for purposes of denying disability payments.

[Whoa_Nelly]

3. The inside of the cranium where the frontal and temporal lobes rest

has many sharp points. According to what I've recently learned, it doesn't take much for the temporal and/or frontal lobe to be permanently damaged when there is even a small scraping/injury by the bone.

[AngryAmish]

7. Not the same injury

"mild" TBI is a brain injury where the damage cannot be seen macroscopically. The damage is microscopic (connections between individual neurons are broken and some neurons are torn apart and killed).

The damage can be anywhere in the brain (tho inner structures are much less effected due to the nature of the structures in the brain and the fact that there tends to be more acceleration/deceleration on the outer surfaces of the brain.)

[NickB79]

4. Pressure wave from the blast?

What they used to call shell-shock back in WWI?

[Tempest]

5. That would be a damned good guess

The concussions suffered from the blasts have got to be horrendous.

Imagine sitting in an armored hummer and have a powerful IED go off right next to, or underneath you.


I can't believe these so-called educated doctors can't figure this out.

[uppityperson]

11. I feel very much for anyone with post-concussion or brain injuries, even mild. However

However, and I do not expect the VA to actually do much, there is a chance that with enough yelling and screaming and pushing of various whomevers, that mild traumatic brain injuries might get studied more and better treatments figured out. Having suffered from a MTBI the last 1 1/2 yrs, I must say it is very odd a lot of the time. I don't have PTSD added in, and really really really feel for these people who do. Will it get researched more or will these people get shoved out the door and onto the street?

k&r

[babylonsister]

12. Baffles? Not so much. Please read this:

http://scoop.epluribusmedia.org/story/2007/4/22/131041/441

big snip//


Brain trauma is the signature injury of the Iraq war. As increasingly elaborate body armour protects the torso, and even the limbs, the brain is still vulnerable to shock waves that helmets cannot deter.

For the first time, the U.S. military is treating more head injuries than chest or abdominal wounds, and it is ill-equipped to do so. According to a July 2005 estimate from Walter Reed Army Medical Center, two-thirds of all soldiers wounded in Iraq who don't immediately return to duty have traumatic brain injuries.

Here's why IEDS carry such hidden danger. The detonation of any powerful explosive generates a blast wave of high pressure that spreads out at 1,600 feet per second from the point of explosion and travels hundreds of yards. The lethal blast wave is a two-part assault that rattles the brain against the skull. The initial shock wave of very high pressure is followed closely by a huge volume of displaced air flooding back into the area, again under high pressure. No helmet or armor can defend against such a massive wave front.

It is these sudden and extreme differences in pressures -- routinely 1,000 times greater than atmospheric pressure -- that lead to significant neurological injury. Blast waves cause severe concussions, resulting in loss of consciousness and obvious neurological deficits such as blindness, deafness and mental retardation. Blast waves causing traumatic brain injuries can leave a 19-year-old who could easily run a six-minute mile unable to stand or even to think.

Referred to as "the silent injury," in many cases the damage caused by concussive waves is not immediately apparent. And these "closed-head" injuries are harder to treat than even those commonly suffered by motorcyclists.

Traumatic brain injuries from Iraq are different, said P. Steven Macedo, a neurologist and former doctor at the Veterans Administration. Concussions from motorcycle accidents injure the brain by stretching or tearing it, he said. But in Iraq, something else is going on.

"When the sound wave moves through the brain, it seems to cause little gas bubbles to form," Macedo said. "When they pop, it leaves a cavity. So you are littering people's brains with these little holes."

Indeed it appears that even those troops who are not at close proximity to IED blasts can be affected. It is estimated that one third of our combatants may be suffering brain injuries, many who don't even know that damage has occurred. This has prompted the VA to start screening all Iraq and Afghanistan veterans who enroll. That will still leave roughly two thirds unexamined, as most never apply for veteran's health benefits. More tragic, the Pentagon has demonstrated far less vigilance than the VA in addressing these pernicious injuries.

What's baffling is the Pentagon's failure to work with Congress to provide a steady stream of funding for research on traumatic brain injuries. Meanwhile, the high-profile firings of top commanders at Walter Reed have shed light on the woefully inadequate treatment for troops. In these circumstances, soldiers face a struggle to get the long-term rehabilitation necessary for treatment of a traumatic brain injury. At Walter Reed, Macedo said, doctors have chosen to medicate most brain-injured patients, even though cognitive rehabilitation, including brain teasers and memory exercises, seems to hold the most promise for dealing with the disorder.

In fact, last summer the Pentagon reacted to the startling numbers of brain injuries by cutting it's funding request for treatment and research of the problem in half; from $14 million to $7 million.

more...

[susanna]

13. IIRC, that is one of the signs of PTSD, especially

In folks in their 30s. I happen to know because I suffer somewhat from it. Not because someone nearly blew me up, but because I had a stalker who made my life a living hell for five years.

There did come a time of forgetfulness about the normal things of life during my experience; I chalked it up to aging, until my therapist mentioned it was one of the symptoms of PTSD (I had multiple others, as well, so it wasn't a stretch). It isn't intentional; you don't sit there and think, "I'm not going to remember" something - it's like you forget the patterns of life. It literally is a brain and endocrine (sp?) system overworked to the point of collapse, and it sometimes functions improperly. I can vividly remember standing in a store and thinking, "I came here for something; what was it?"

These days, I play video-game poker and sudoku (laugh if you want) to re-orient my brain to understand patterns - that seems to help me, in particular (I'm a pattern girl). It seems to help a great deal with the problem, honestly. The only problem is that now none of my friends will play me in Texas Hold 'Em. ;-)

on edit: clarity

[babylonsister]

14. All lies. See post #12. nt