T Nation

Soldiers May Suffer from Brain Injury

A Fifth of Soldiers May Suffer from Brain Injury, Army Says
St. Louis Post-Dispatch - January 17, 2008

WASHINGTON - The Army acknowledged Thursday that as many as one of every five soldiers or Marines exposed to combat in Iraq or Afghanistan suffers from a hard-to-detect form of traumatic brain injury.

That finding about mild traumatic brain injury, contained in the Army task force’s report released Thursday, has prompted the Army to order the screening of every returning soldier.

The study, begun in January of 2007, marks the first time the Army - which provides the bulk of the troops for the wars in Iraq and Afghanistan - has focused exclusively on traumatic brain injuries.

It reinforces the contention of many military and medical experts that traumatic brain injuries are the “signature injuries” of the Iraq and Afghan conflicts, because of the nature of the fighting, the exposure of personnel to attack at any time, rapid medical treatment that enables soldiers to survive horrific injuries and - most of all - the widespread use of explosive devices.

Army officials said that while a good job has been done identifying and treating severe forms of traumatic brain injury, cases of mild TBI, or concussions, are harder to detect and more prevalent, so more aggressive action on the part of the military is required.

Symptoms related to more severe cases of traumatic brain injury affect additional numbers of soldiers, Army officials told the St. Louis Post-Dispatch Thursday night, with nine percent of soldiers who’ve seen combat showing signs of medium TBI, six percent showing signs of severe TBI and five percent having what are known as penetrating head wounds.

Difficulties in dealing with the unexpected volume of such injuries at the federal level have led some states to take steps on their own. This month, Illinois is instituting the first program among states to screen all returning National Guard troops for traumatic brain injuries.

Asked about Illinois’ program, Brig. Gen. Donald Bradshaw, who headed the Army’s TBI Task Force and who led Thursday’s briefing at the Pentagon, said states had the right to take such action, but added, “Do I think it’s necessary? No, because we have ongoing screening processes we’re continuing to fine tune.”

Tammy Duckworth, director of the Illinois Department of Veterans Affairs and an Iraq veteran who lost both legs to a rocket-propelled grenade in 2004, said Illinois is “not in competition with the active-duty Army.”

“Our program is meant to be that safety net in the state of Illinois, to make sure nobody falls through the cracks,” she said, noting that Illinois’ program handles Marines, Navy and Air Force veterans as well as Army veterans, and treats those who’ve left the military within the past five years but now need help.

Rep. Phil Hare, D-Ill., a member of the House Veterans Affairs Committee, said the Army’s steps are “long overdue.”

“You’re talking a completely different war here,” he said. “You’re looking at literally thousands of people who’ve been harmed and don’t know they’ve been harmed. For the Army to tell the states they’re on top of this, it’s a little bit silly because they’re not on top of this. I’m very proud of Illinois.”

The military has discharged 23,000 troops since 2001 for “pre-existing personality disorders” the military says the troops had before they joined the service. The discharges have outraged members of Congress, with legislators seeking ways to restrict the military’s use of the practice. Asked whether some of those discharged could actually have had traumatic brain injuries, Col. Robert Labutta, a neurosurgeon in the office of the surgeon general, said, “We’ve been asking the question, because the potential is there.”

Sen. Christopher “Kit” Bond, R-Mo., has proposed a special presidential panel to review those 23,000 cases. Thursday’s report shows the need for the panel, said Sen. Claire McCaskill, D-Mo., of the Senate Armed Service Committee. She praised the Army’s actions in dealing with “a deep wound” among soldiers.

“However, the concern remains about those who came home prior to this report and were misdiagnosed with other conditions, including personality disorders, which jeopardized their medical benefits and opportunities for treatment,” she said. “This report proves more than ever that Sen. Bond’s proposed review board, which I am proud to support, to evaluate those cases of potential misdiagnoses is necessary.”

The Army is now building up staffing so every soldier receiving an administrative discharge will be screened for traumatic brain injury, Labutta said.

© 2008, St. Louis Post-Dispatch. Distributed by Mclatchy-Tribune News Service.