It strikes boxers, cyclists, hockey and football players with alarming frequency. Once the outward cuts and bruises have healed, the lingering effects of a severe blow to the head can stealthily wreak havoc on the brain, creating long-term deficits in memory, mood and cognition.
Known as traumatic brain injury (TBI), the condition has gained national prominence as star athletes have publicly acknowledged their struggles.
Now, the medical community is sounding the alarm about the prevalence of TBI among soldiers, who face comparable risks as they engage in rigorous training, athletics and combat.
Since 2000, there have been 344,000 documented traumatic brain injuries among service members, according to Sammy Choi, M.D., director, department of clinical investigation at Womack Army Medical Center.
Bullets, blasts, falls, assaults, sports, training mishaps and cars crashes are among the dangers soldiers face at home and abroad, Choi noted.
Choi was among a panel of experts who presented the latest advances in TBI research, screening and treatment at a symposium, Medical, Biomedical & Biodefense: Support to the Warfighter Symposium, held at the North Carolina Biotechnology Center last week.
Much of the current knowledge about treating trauma has emerged from the front lines, where necessity dictates drastic measures to save lives and reduce long-term disability. Likewise, many of the new screening techniques for trauma and TBI are being employed by the military to quickly assess brain status after an injury.
Among the latest technology is Brainscope Ahead 200, a hand-held device that interprets the structural condition of a person’s brain to determine whether a CT scan is needed following a TBI. Another product, the Infrascan Infrascanner, uses infrared light to detect brain hematomas – leaking blood that can clot and compress brain tissue, causing dangerous consequences.
Yet despite these recent advances in screening, there is still no definitive test or standard treatment for TBI, the panelists noted. Moreover, no two head impacts are the same, meaning that treatments must be tailored to the unique manifestations of each person’s trauma.
Botox injections can reduce pain from chronic headaches. Tranexamic acid can lower the incidence of re-bleeding in spontaneous intracranial bleeding. Diets rich in Omega 3s exert anti-inflammatory and neuroprotective effects on the brain. And neuroactive steroids such as pregnenolone may improve cognitive deficits and reduce anxiety and depression symptoms following TBI.
Research protocols abound, but the intricate nature of brain function poses a huge challenge to the medical community at large, whose understanding of the human brain lags behind that of other organ systems.
“NIH focuses on chronic diseases, not research programs in trauma,” said keynote speaker Colonel Dallas Hack, a former medical advisor in the U.S. Army Medical Research and Materiel Command.
The takeaway message from panelists: more funding and greater resources must be channeled into scientific research and clinical studies to understand the basis of traumatic brain injury and how best to prevent and treat its devastating consequences.
