Brain Trauma From Blasts Prevalent But Hidden

Many U.S. soldiers exposed to blasts in Iraq and Afghanistan may have suffered brain injuries that never got diagnosed, says the Institute of Medicine today in a report that raises new questions about whether soldiers are adequately protected on the battlefield. Released this morning, the report notes that military personnel with severe, moderate, or mild traumatic brain injury (TBI) are at an increased risk for developing mental and psychiatric illnesses like dementia, aggression, depression, and memory loss.

The findings of the study, sponsored by the Department of Veterans Affairs, add to a rising tide of concern about the long-term health consequences of improvised explosive device attacks in Iraq and Afghanistan. Although advances in body armor and helmets have helped reduce deaths and mutilations from explosions, some researchers such as neurologist Ibolja Cernak of the Johns Hopkins University Applied Physics Laboratory say that shock waves from these blasts may be resulting in brain trauma even without visible wounds to the skull. Cernak's controversial hypothesis that blast waves are transmitted into the brain through oscillations in pressure in the victim's blood vessels has led to questions about whether helmets provide adequate protection.

Cernak is on the committee that authored the Institute of Medicine report. Among other things, it recommends that the military conduct neurocognitive testing on all soldiers before deployment to establish a baseline of mental health and then screen every soldier who experiences or witnesses a blast, even from a great distance, for TBI. It also calls for more animal studies to study blast-induced brain trauma and inclusion of a control group of non-TBI veterans in the Traumatic Brain Injury Veterans Health Registry to enable meaningful comparisons for research purposes.