Wartime troop brain injures could reach 360,000

The number of U.S. troops who have suffered wartime brain injuries may be as high as 360,000 and could cast more attention on such injuries among civilians, Defense Department doctors said Wednesday. The estimate of the number injured–the vast majority of them suffering concussions–represents 20 percent of the roughly 1.8 million men and women who have served in Iraq and Afghanistan, where blast injuries are common from roadside bombs and other explosives, the doctors said. The estimate came in a Pentagon news conference on activities planned this month to bring attention to brain injuries. The doctors said the number could be as low as 180,000, based on estimates that between 10 percent and 20 percent of troops might have received such injuries. The previous high estimate offered publicly was 320,000 in a study released a year ago by the private Rand Corp. It was based on about 1.6 million who had done tours of duty in the wars from late 2001. As Army officials announced the beginning of Brain Injury Awareness Month, they offered up a figure that makes it hard to believe anyone in the military could be unaware of the problem: Between 45,000 and 90,000 troops have been treated for traumatic brain injury symptoms ranging from headaches to vision problems to an inability to function beyond a coma state. Brig. Gen. Loree Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, said between 10 percent and 20 percent of soldiers and Marines–about 180,000 people–have screened positive for TBI. Yet military doctors still fight a culture in which some troops believe they can head right back into the fight after being exposed to a blast–even though high school football players know better than to play again for a few days–and commanders may decide to risk sending someone outside the wire after an injury because there aren't enough people to make up a patrol team. Experts at the U.S. Military Academy have said it's important for someone who has suffered even mild TBI to avoid the risk of re-injuring the brain–especially the not-yet-fully-grown brain of someone younger than 24–because a second injury can lead to permanent damage or even death. Declaring March as Brain Injury Awareness Month serves as a reminder to troops to watch out for themselves and each other. A brain injury results from a blow to the head or from the waves of a blast from an explosive device. Any altered state–passing out for a few seconds or minutes, dizziness or a foggy memory–constitutes an injury, and they range from mild, or a concussion, to severe. Symptoms that can last hours, days or years include loss of balance, short-term memory loss, vision problems, tinnitus or ringing in the ears, headaches, seizures, irritability, sleep problems, or an inability to concentrate. Sutton said the symptoms usually go away on their own, especially if troops "allow themselves to get the rest that they need." If the problems don't go away, doctors can treat the symptoms with medications and therapy. Sutton stressed that 80 percent to 85 percent of TBIs are categorized as "mild," but even mild TBI can cause headaches, vision problems and short-term memory loss. However, she said people are much more likely to quickly recover from a mild injury. More than half of such injuries come from explosions. About half the service members who screen positively for TBI recover on their own, while one-fourth recover with the help of treatment and one-fourth need specialty care. Over the past year, Sutton said the military has begun doing a better job of screening service members in the field so exposures to blasts or blows can be recorded and treated. The Defense and Veteran's Brain Injury Center also has increased its network of civilian and military doctors and therapists to come up with better treatments and screening methods. Troops also have begun taking the Automated Neuropsychological Assessment Metric, which gives doctors baseline information on a person's cognitive skills before an injury occurs. The new National Intrepid Center of Excellence, which is expected to open next year in Bethesda, Md., will specialize in TBI and psychological health issues. Last year, the Army spent $242 million on care for TBI, according to Lt. Col. Lynn Lowe, chief of the operations branch proponency office for rehabilitation and reintegration in the office of the Army Surgeon General. Those with questions about TBI or any psychological health issue can call the Army's outreach center at (866) 966-1020.