Traumatic Brain Injury (TBI) is the “signature wound” of the wars in Iraq and
Afghanistan. If you were exposed to a blast, were in a vehicle crash, or had your
head hit or jolted while you were deployed, you might have a brain injury.
Mild to moderate brain injury, also called a “closed head” injury, may not reveal itself with noticeable symptoms at the time the injury happens. A person can become symptomatic
many months after the injury occurred. Changes in behavior and mood, sleep patterns, and the ability to concentrate or remember things might be affected. This can have long-term consequences for you and your family.

Learning how your brain might have been affected will give you important information for diagnosis and treatment. It is critical that family members, friends and colleagues observe changes that may occur in service members returning from combat. These changes may indicate the presence of a TBI or post-traumatic stress disorder (PTSD).
If you can answer “yes” to any of these questions, you may have a combat-related traumatic brain injury.

Have you ...

• Had persistent trouble sleeping?
• Experienced memory loss?
• Found yourself confused or disoriented?
• Had difficulty concentrating?
• Been depressed, anxious, or irritable?
• Had a headache, ringing in your ears, blurred vision, or neck pain?
• Felt dizzy or suddenly lost your balance?
• Experienced blackouts?
• Felt unusually tired or fatigued?
• Experienced increased sensitivity to bright light and noise?

While you were deployed, were you injured by a ...

• Bullet, fragment, or shrapnel, etc.?
• Vehicle accident (any type)?
• Blast (IED, RPG, land mine, grenade, etc.)?

Were you near an IED, RPG, land mine, or grenade when it exploded? (See more about blast injury below)
Did any injury you sustained while you were deployed result in any of the following:

• Feeling dazed or confused?
• Not remembering the injury?
• Loss of consciousness?
• Having any symptoms of concussion afterward (headaches, dizziness, irritability, light and noise sensitivity, ringing in your ears)?
• Injury to the head or face?

If you can answer “yes” to any of these questions, you may have a combat-related traumatic brain injury. The only way to find out is to talk to a professional who understands. The Brain Injury Association of New York State wants to help returning military and their families with information, support, and referrals for help. Please call our Family Help Line at 1-800-228-8201.

Blast Injury and Traumatic Brain Injury

America's armed forces are sustaining attacks by rocket-propelled grenades, improvised explosive devices, and land mines almost daily in Iraq and Afghanistan. These injured soldiers require specialized care from providers experienced in treating traumatic brain injury.

Blast injuries have become common in military conflicts. It has been estimated that over 50 percent of injuries sustained in combat are the result of explosive munitions including bombs, grenades, land mines, missiles, and mortar/artillery shells.

The data on blast-induced brain injury is very limited, but studies that have been done are very persuasive. Between July and November, 2003, the Defense and Veterans Brain Injury Center at Walter Reed Army Medical Center screened 155 patients who had returned from Iraq and were deemed to be at risk for TBI. Ninety-six of the 155 screened, or 62 percent, were identified as having sustained a brain injury. Of the 88 blast cases included in the total number screened, 61 percent were identified as having sustained a TBI.

Blast injuries result from the complex pressure wave generated by an explosion. The explosion causes an instantaneous rise in pressure over atmospheric pressure that creates a blast over-pressurization wave. Primary blast injury occurs from an interaction of the over-pressurization wave and the body with differences occurring from one organ system to another. Air-filled organs such as the ear, lung, and gastrointestinal tract, and organs surrounded by fluid-filled cavities such as the brain and spine, are especially susceptible to primary blast injury. The over-pressurization wave dissipates quickly, causing the greatest risk of injury to those closest to the explosion.

In a blast, brain injuries can also occur by other means, such as impact from blast-energized debris, the individual being physically thrown, burns, and/or inhalation of gases and vapors.