Saturday, October 30, 2010

With new military rules, doctors are diagnosing hundreds of concussions among combat troops, which helps prevent permanent brain injury

From USA Today. In the picture, Army Spc. Daus Hempker, 22, Lima, Ohio, right, goes through an exam with Navy Capt. Michael Wagner, a neurologist and the traumatic brain injury director at the Kandahar Air Field Role 3 Medical Treatment Facility.

KANDAHAR AIR BASE, Afghanistan — Military doctors are diagnosing hundreds of concussions among combat troops because of an unprecedented order requiring them to leave the battlefield for 24 hours after being exposed to a blast.

Doctors say the order helps prevent permanent brain damage that can result if a service member has a second concussion before the first one heals.

"For the last eight years prior to the implementation of these protocols, we weren't doing things the right way," said Gen. Peter Chiarelli, the Army vice chief of staff.

Concussions among U.S. troops in Afghanistan increased from 62 diagnosed cases in June to 370 in July when the new rules were imposed, according to the U.S. Central Command, which oversees combat here.

From July through September, more than 1,000 soldiers, Marines and other U.S. servicemembers were identified with concussions, more than twice the number diagnosed during the previous four months, Central Command says.

"I'm certainly never happy to see the rate of any wound increase, (but) I think the data clearly demonstrates that TBI (traumatic brain injury) is getting the attention it deserves," says Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, who pushed for the new rules. "Battlefield leaders are taking the issue seriously and getting their troops the help they need."

Under the new policy, troops caught within 165 feet of a blast (about half the length of a football field) must be pulled from the battlefield for at least 24 hours and examined for evidence of a concussion. The same goes for troops in a vehicle or building struck by a bomb.

Symptoms include brief loss of consciousness, clouded thinking, dizziness and headaches. Ninety percent recover from their symptoms and return to combat, although this can take days or weeks.

The data show that concussions may be far more common in combat than previously known and may suggest that thousands of these casualties may have been missed earlier in the Iraq and Afghanistan wars, Mullen says.

Roadside bombs are the most common source of injuries to U.S. troops. Troops in the past tended to shake off blast effects and continue fighting, according to Army field studies.

To treat symptoms of concussions, the military has set up five "rest centers" here where troops can recover, says Army Lt. Col. Kristofer Radcliffe, a neurologist supervising the effort. Scientists warn, however, that it is unclear whether the brain has healed even if symptoms go away.

"Unfortunately, we still don't know," says Ibolja Cernak, a brain-injury scientist at Johns Hopkins University Applied Physics Laboratory.

Others worry that the policy could leave too few troops for combat.

"You want to look out for the welfare of your men and women. At the same time, you want to win the fight," says David Reist, a retired Marine Corps brigadier general who fought in Iraq. "Those two things are diametrically opposed sometimes."