Most Soldiers With Brain Injury Heal, Medical Official Says

By C. Todd Lopez
Special to American Forces Press Service

March 5, 2009 - Mild traumatic brain injury, also known as a concussion, affects from 10 to 20 percent of servicemembers returning from combat deployment in Iraq or Afghanistan. During a roundtable discussion at the Pentagon yesterday as part of "Brain Injury Awareness Month," Army Brig. Gen. (Dr.) Loree K. Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, said more than 90 percent of servicemembers with TBI have concussions and recovery quickly.

"I can't stress this enough," Sutton said. "The vast majority of people with TBI will get better. Certainly, the moderate or more severe cases will take longer to recover, but it is also important to recognize this is not an individual concern alone. That's where family comes in, the unit comes in, and the community comes in."

Mild TBI -- concussions -- are the result of a blow to the head, and can result in disorientation, headaches, dizziness, balance difficulties, ringing in the ears, blurred vision and memory gaps. The Army and other services screen for concussions with a tool called the Military Acute Concussion Evaluation. The tool, recently supported by the Institutes of Medicine, was first released in August 2006.

The military also uses the Automated Neuropsychological Assessment Metric, or ANAM, to set baselines for servicemembers before deployment. The tool establishes a baseline for a soldier's reaction time, short-term memory and other cognitive skills, and providers can use the results as another critical piece of information for the evaluation and management of injured servicemembers, Sutton said.

"We've directed a lot of research and time and energy to identifying the knowledge gaps for the entire range of traumatic brain injury, which spans from concussion, or mTBI, all the way through to severe TBI," Sutton said. "The good news is that for 80 to 85 percent of people that experience TBI, it is a concussion, and most folks will recover quickly -- particularly if they pay attention early on and get the rest they need. Early intervention is important."

The Defense and Veterans Brain Injury Center, established after the first Gulf War, reports that some 33 percent of patients who needed medical evaluation for battle-related injuries at Walter Reed Army Medical Center here in 2008 had TBI. Cumulatively, the center's sites have seen more than 9,000 patients who suffer from TBI. Sutton said it is important for soldiers who think they may have suffered an injury that might lead to TBI to self-report to ensure the best possible recovery.

"Our troops are very motivated and want to stay in the fight," she said. "But our message is if you hurt your arm or you hurt your leg, you'd get it taken care of. Well the same thing applies to one's brain. So asking for help is an act of courage and strength, and we have a great system set up both within [the Defense and Veterans Affairs departments] and in partnership with our civilian colleagues."

In June, Defense Department officials broke ground on the National Intrepid Center of Excellence for Psychological Health and Traumatic Brain Injury at Bethseda, Md. The $70-million, 75,000-square-foot facility will be a state-of-the-art treatment and rehabilitation center.

"The National Intrepid Center of Excellence will become the hub of our national and global network, so we can draw on the expertise around the country and around the world, particularly on those individuals that are not getting better as we hoped they would," Sutton said.

(C. Todd Lopez works for Army News Service.)