Concussions and the Military: Issues Specific to Service Members

Abstract

Since October 2001, more than 1.6 million American military service members have deployed to Iraq and Afghanistan in the Global War on Terrorism. It is estimated that between 5% and 35% of them have sustained a concussion, also called mild traumatic brain injury (mTBI), during their deployment. Up to 80% of the concussions experienced in theater are secondary to blast exposures. The unique circumstances and consequences of sustaining a concussion in combat demands a unique understanding and treatment plan. The current literature was reviewed and revealed a paucity of pathophysiological explanations on the nature of the injury and informed treatment plans. However, through observation and experience, a theoretical but scientifically plausible model for why and how blast injuries experienced in combat give rise to the symptoms that affect day-to-day function of service members who have been concussed has been developed. We also are able to offer treatment strategies based on our evaluation of the current literature and experience to help palliate postconcussive symptoms. The purpose of this review is to elucidate common physical, cognitive, emotional, and situational challenges, and possible solutions for this special population of patients who will be transitioning into the civilian sector and interfacing with health professionals. There is a need for further investigation and testing of these strategies.

Headache in military service members with a history of mild traumatic brain injury: A cohort study of diagnosis and classification

“…In the military (13) and all other environments, diagnosing post-traumatic headache (PTH) requires a wellexecuted history and physical examination, including accounting for differences in populations (14,15). Headaches after concussion are highly prevalent (16)(17)(18), relatively persistent (19) and are usually treated based upon primary headache nosology (20)(21)(22).…”

Multiple Past Concussions Are Associated with Ongoing Post-Concussive Symptoms but Not Cognitive Impairment in Active-Duty Army Soldiers

“…Reports suggest that between 5% and 35% of military service members have sustained a concussion, often referred to as a mild traumatic brain injury (mTBI), during deployments. 1 The Defense and Veterans Brain Injury Center (DVBIC) reports that since 2000 there have been 247,904 service members with mTBI (http://dvbic.dcoe.mil/dod-worldwidenumbers-tbi). Multiple concussions are of particular concern to the military given the ongoing risk of repeat mTBI exposure during active duty.…”

Comparing Treatment Outcomes Among Canadian Military and Civilian Substance Users Attending the Same Residential Treatment Program

“…Therapy groups comprising exclusively military members would have a shared understanding of the cultural context in which they work and might more easily relate to one another regarding the stressors of military life, balancing family and work, and reintegration into civilian life. Militaryspecific substance use treatment programs have been evaluated and were found to be effective (Rigg & Mooney, 2011). Therefore, it may be beneficial for military members to receive addiction treatment within their employment context.…”