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Health Risk of TBI in Military Operations, Essay Example

Pages: 6

Words: 1765

Essay

Although the research is still being performed in this area, it is clear that traumatic brain injury (TBI) has become a major health risk.  In many walks of life, from young children falling, bicycle accidents, and sports, TBI is particularly common.  Overall, according to the Centers for Disease Control and Prevention, 1.7 TBIs occur in the United States each year, based on numbers from 2002 to 2006 (Silver, McAllister, and Yudofsky, 2011).

The current analysis explores both TBI itself, and, more importantly, how it interacts with health care risk in the military.  Along with other conditions that are becoming better understood, such as PTSD, TBI is a major risk for individuals in military service.  This analysis looks at the facts and the reality that comes with it, in terms of increased awareness and medical/psychological support.

What Is TBI?

As one may expect, defining TBI is an important task at hand.  However, not too many are aware of the specifics surrounding the position, especially when it is outside of those affected (those individuals and families affected, the medical community, etc.).  Such clarifications must be made, along with other misunderstandings regarding TBI.

TBI occurs whenever the brain is traumatically injured, which is not limited to a specific location within the brain.  A major cause of death and disability, it is not to be confused with head injury, which is a broader category that may involve other structures like the scull.  Furthermore, it is important to note that a concussion is a specific type of TBI, often in the “mild TBI” category.

In general terms, there are two major effects that occur in a TBI. There is obviously a number of different results that may occur as a result of the initial impact. The moment of injury is the primary injury, which is caused by the impact or acceleration involved in the TBI.  There is also secondary injury, involving pressure in the skull and blood flow, for instance, that takes place in the moments (immediate and long-term) following the injury.

Mild TBI will typically last a few weeks, and possibly longer.  It is normally battled well with effective treatment and therapy.  Moderate TBI requires hospitalization and neurosurgical care, and may also involve the development of postconcussive syndrome (Elsayed and Atkins, 2008).  Finally, severe TBI involves advanced care when the patient is either comatose or obtunded; many patients with severe TBI will not survive to one year (2008).

The effects of TBI can be devastating.  While the moderate levels of TBI are normally do not involve long-term disability or such drastic effects, any level of severity has that kind of potential.  TBI has a number of cognitive, emotional, physical, and behavioral effects, which can result in death or some type of permanent disability.  Rehabilitation can take on many forms, from counseling to physical and speech therapy.

TBI in the Military

A primary portion of this analysis is to approach the prevalence and risk associated with TBI in the military.  As it will be demonstrated, TBI is a particular and significant risk for military personnel.  Experts draw parallels to other conditions, interestingly, such as PTSD, as common conditions as a result of military duty.

Prior to looking at the claims suggested by some sources, it is important to identify the lack of appropriate research in this field.  The statistics are often isolated to the study, rely on self-reported data (Elsayed and Atkins, 2008), and are not generally as reliable as in other fields.  Consider that “there has not been a comprehensive scientifically rigorous epidemiological study conducted on this condition (2008).  However, perhaps these statistics and reports, however inconclusive and needing of supportive evidence, shed some light on the situation.  TBI in the military is, at any rate, a significant topic to approach and understand.

There have been some statistics that put the prevalence of TBI for military personnel in perspective.  Elsayed and Atkins (2008) report that “numerous articles in the popular lay media have reported prevalence of bTBI [blunt TBI] approaching 40 to 60% of deployed U.S. warfighters.”  Though it’s not exactly a confirmed statistic, it does provide some background to realizing how common TBI may be in the military.

These numbers are found elsewhere.  Lawhorne (2011) states that “… [TBI] is often referred to as the ‘signature wound’ of the global war on terror,” and that it “could account for up to 50 percent of combat-related casualties…”  Of course it will remain important for further studies and statistics to support such claims.

Military service increases the risk of sustaining a TBI, according to the Defense and Veterans Brain Injury Center(DVBIC, 2009).  Males are also at an increased risk, estimated at 1.5 times as likely as females (2009).  While all of the aforementioned reports and statistics need further confirmation and research, the relationship between military service and the likelihood of experiencing a TBI is substantially greater than in other contexts.

A sustained TBI can come as a result of a number of objects and events, in regards to military service.  The DVBIC (2009) notes that blasts are a leading cause for active duty personnel in war zones.  Bullets, fragments, falls, motor vehicle-traffic crashes, and assaults are among the other leading causes for TBI in the military (2009).

In addition to the previous information, more statistics give further depth into the problem.  Silver, McAllister, and Yudofsky (2011) report that 27,862 medically diagnosed TBIs were reported in 2009, including battle-related injuries and those that were not battle-related.  Also, 7.1% of Department of Veterans Affairs (VA) service members had a history of TBI with persisting symptoms.  These figures certainly shed light on the situation, and are positively more reliable than previous estimates and qualitative assessments, however still important.

Complications for TBI in Military Personnel

The health risk for military personnel is further confirmed with the many complications involved.  There are significant health complications for military personnel that are not seen elsewhere, which forms an important role in current needs in this field.  This is a topic that is receiving much attention today.

This significant health complication is known as blast induced traumatic brain injuries (BINT, Blast Induced Neuro Trauma).  While TBI is already a major health problem for military personnel, BINT proposes further difficulties.  Some sources claim that BINT could pose explicitly new problems, from classification in relationship with TBI and PTSD to new treatments that may be required.

Research had demonstrated the new concepts that are coming by way of BINT, as opposed to TBI.  Cemak and Noble-Haeusslein (2010), in their review,  state that “what is clear from the effort to date is that the pathobiology of military TBIs, particularly BINT, has characteristics not seen in other types of brain injury, despite secondary injury cascades.”  These problems could certainly pose difficulties in such fields, not to mention an increased risk for military personnel.

BINT has a number of effects that are catching the attention of researchers.  The pathology of BINT is said to be extremely complex, involving activation in the autonomous nervous system, sudden pressure-increase in vital organs, and activation of neuroendocrine-immune system (2010).  Such biological effects are becoming a prime target for researchers who wish to understand the dynamics of BINT.

Discussion

Overall, and not exclusive to the aforementioned discussion of BINT, it is easy to report that there are plenty of complications to the overall analysis.  There are significant health risks posed by TBI, including the different levels and that of BINT.  From definitions, protective gear, further research, and of course better treatment, there is much progress to be made in this general area.

The understanding of these dynamics is not well understood.  Silver, McAllister, and Yudofsky (2011) call for “clinically meaningful” definitions and screening tools.  This will arguably go a long way in both medical and lay fields.  Improving the understanding and awareness of TBIs, from a mild concussion to BINT, is essential for overall progress to be made in time.

Research is one area that is in dire need today.  While there are some helpful stats which put TBI and other elements in perspective, both in and outside of military operations, it is not enough.  More research is needed to aid the awareness of these conditions, and help toward better general awareness in the public, recognition of such conditions, and the prevention and treatment of them.

The medical field will be an important element for the improvement of current treatment.  Many sources give treatment as the most important need in relationship to TBI in military operations.  From counseling to issues of permanent disability, research should undoubtedly help the health and support of individuals with these conditions improve.  In time, perhaps there will be additional steps and awareness that will serve military personnel to improving, both the awareness and prevention, of these conditions.

Conclusion

While, once again, the research and exact numbers are for the most part lacking, there is a stronger connection to TBI in military circles and personnel than other common populations.  The health risk of TBI in military operations is generally said to be confirmed, where such personnel are at an increased risk.  Moreover, concussions and BINT, other forms of TBI, are also common health risks for military personnel.

TBI represents a serious condition that should be treated with proper care.  Certainly, a large portion of TBIs are not threatening in the long term and improve in a few days.  However, proper recognition is required, along with proper treatments, to aid an individual who has suffered a potentially-threatening TBI.

There are plenty of areas that are in need for these topics.  Pure data and research on the prevalence of such conditions is lacking.  In addition, a condition such as BINT is not well-understood, according to current medical literature, which will be important to address in order to obtain proper care.

Overall, there are many needs in this discussion.  Many do not feel that TBI is properly understood or treated, along with the recognition of it in military contexts.  However, it is important to progress to these ends, if this topic is to be given the right attention and care.  Certainly TBI is a health risk that rises in regards to military personnel.

References

Cernak, Ibolja and Linda J Noble-Haeusslein.  (2010).  Traumatic brain injury: An overview of pathobiology with emphasis on military populations.  Journal of Cerebral Blood Flow & Metabolism, 30, 255-266.

DVBIC.  (2009).  TBI Facts.  Defense and Veterans Brain Injury Center.  Retrieved from http://www.dvbic.org/TBI—The-Military/TBI-Facts.aspx.

Elsayed, Nabil M. and James L. Atkins. (2008).  Explosion and blast-related injuries: Effects of explosion and blast from military operations and acts of terrorism.  Burlington, MA: Elsevier Academic Press.

Lawhorne, Cheryl.  (2011).  Combat-related Traumatic Brain Injury and PTSD: A resource and recovery guide.  Lanham, MD: Government Institutes.

Silver, Jonathan M., Thomas W. McAllister, and Stuar C. Yudofsky.  (2011).  Textbook of Traumatic Brain Injury.  Arlington, VA: American Psychiatric Association.

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