Unpacking the Trauma of War Injuries

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Traumatic brain injury effects vary little based on method of injury

June 17, 2014 / Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

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(dailyRx News) Traumatic brain injury has been one of the signature injuries to result from the US involvement in Iraq and Afghanistan. But there is more than one way to get this injury.

A recent study found, however, that how a person gets a traumatic brain injury does not seem to affect the symptoms they experience.

Those who experienced a traumatic brain injury due to a blast did not show differences in their symptoms than those who had a traumatic brain injury for other reasons.

In fact, even symptoms of post traumatic stress disorder (PTSD) did not seem to vary among those with traumatic brain injury based on how they got it.

"Describe all your symptoms to your neurologist following traumatic brain injury."

The study, led by Christine MacDonald, PhD, of the Department of Neurology at Washington University School of Medicine in St. Louis, Missouri, looked at the effects of different causes of traumatic brain injury (TBI).

The researchers tracked 178 US military personnel who had been evacuated from Iraq or Afghanistan between 2010 and 2013 for one of four reasons.

The participants included the following:

  • 53 participants who got TBI following a blast
  • 29 participants who had TBI due to reasons other than a blast
  • 27 participants who were exposed to a blast but did not have TBI
  • 69 participants not exposed to a blast and without TBI who were evacuated for other medical reasons

These participants underwent assessments for their overall disability, frequency and severity of headaches and neurological functions.

They also filled out questionnaires related to their combat exposure, their use of alcohol and their symptoms of PTSD and depression.

The researchers found no differences in overall outcomes, in the severity of headaches, in neurological and psychological functions and even PTSD and depression symptoms among the two groups with TBI.

Those with TBI, regardless of how they got it, tended to have higher rates of moderate to severe overall disability than the veterans without TBI.

In fact, 77 percent of the veterans with TBI from a blast and 79 percent of the veterans with TBI from other reasons had moderate to severe overall disability.

Meanwhile, 59 percent of those exposed to a blast but without TBI and 41 percent of those without a blast or TBI exposure ended up with moderate to severe disability.

Among the groups who did not have a TBI, the veterans exposed to a blast had worse PTSD and worse headaches than those not exposed to a blast.

Although the veterans exposed to blasts, with or without TBI, rated themselves as having greater intensity of combat than the other groups, this ranking did not correlate with symptoms of PTSD in the two groups with TBI.

The worst and most common symptoms linked to TBI were depression symptoms, severe headaches and abnormal results in their neurological testing.

The most problematic finding, however, was that "a substantial fraction of the variance in overall outcome was not explained by any of the assessed measures."

This means that substantial differences in outcomes, skills and symptoms varied among all four groups which could not be explained by any of the data gathered by the researchers.

This finding implies that traumatic brain injuries are very complex, as are the effects of combat and other injuries, in terms of understanding their effects on a person.

Yet it does seem that having a traumatic brain injury of any kind, regardless of how it happened, is the biggest factor in the negative outcomes tested in this study.

The study was published June 16 in the journal JAMA. The research was funded by the Congressionally Directed Medical Research Program. The authors reported no conflicts of interest.

Review Date: 
June 16, 2014
Last Updated:
June 17, 2014