Traumatic Brain Injury Update 19

Posted: August 12, 2011 in Uncategorized
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Dr Bruce Capehart, medical director of the OEF/OIF program at the Veterans Affairs hospital in Durham, North Carolina, and Dr. Dale Bass, associate research professor in the Department of Biomedical Engineering at Duke University's Pratt School of Engineering, addressed the "epidemiology, diagnosis, and treatment of mild TBI among combat veterans, with a particular focus on blast injury and the presence of comorbid posttraumatic stress disorder (PTSD)." The authors conclude, "Making an accurate TBI diagnosis in a combat veteran includes obtaining a history of past head injuries, including those injuries not considered significant by the veteran; performing a careful clinical assessment of psychiatric symptoms; possibly referring for neuropsychological testing; and providing symptom-focused treatment. Appropriate treatment can result in significant clinical benefit for the veteran.
A recent Army program will assist providing info on exposure to blasts resulting in TBI. The Army will outfit a brigade of soldiers in Afghanistan in the next few weeks with gauges worn on their bodies that can alert medics to an explosion's severity — proof of possible brain injury. It is the beginning of an effort over the next several months to wire up soldiers and vehicles with sensors, black boxes and digital cameras. The data may shed light on how blast exposures damage the brain, even when a soldier appears only dazed, researchers say. An estimated 300,000 troops have suffered mild brain injuries, mostly from explosions, in Iraq and Afghanistan. "(This) is the beginning of a process…that's going to lead us to collecting the data researchers need to untie this Gordian knot," says Gen. Peter Chiarelli, the Army vice chief of staff.
Sensors will measure blast effects from buried bombs known as improvised explosive devices that have killed nearly 3,000 troops in Iraq and Afghanistan and wounded about 30,000. The newest sensor, developed by the Defense Advanced Research Projects Agency (DARPA) for nearly $1 million, is the size of the timepiece on a wristwatch and weighs less than an ounce. Soldiers will wear three — on the breast and shoulder of their body armor, and on a helmet strap against the back of their necks. "It's an environmental sensor … like a dive watch," says Col. Geoffrey Ling, a DARPA scientist. In addition to recording blast force and over-pressure, data that can be downloaded via a USB port, the device gives an immediate read of bomb severity, says Jeffrey Rogers, a DARPA physicist and one of the inventors. After an explosion goes off near a soldier, a medic inserts a stylus or pen tip into a recessed hole on the device. A light flashes green, yellow or red, indicating whether the blast was strong enough to warrant further medical attention. "We're really worried about the guy who's not complaining," Ling says. A second blast sensor developed by the Army — worn inside the crown of the helmet and measuring how the head is whipped about in a blast — will be used by six brigades by December. That device cost more than $50 million to develop and produce, says Lt. Col. Jon Rickey, program manager. By early next year, the Army also hopes to have 50 to 100 bomb-resistant vehicles in Afghanistan outfitted with sensors in the hull and seats connected to a "black box," says Gary Frost, of the Army's Rapid Equipping Force. [Source: Psychiatric Times &USA Today articles 13 & 18 Jul 2011 ]
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