News studies have documented a decrease in the killed:wounded ratio thanks to advances in medical science. Less than 1 in 10 patients die from their combat-related injuries. Even on the battlefield, there have been great medical innovations. Clinical improvements used to treat traumatic brain injury (TBI) include early decompressive craniectomy, neuro-critical care, cerebral angiography, transcranial Doppler, hypertonic saline, TBI clinical management guidelines, among other techniques.
All the new medical procedures have resulted in a greater survival rate for fighters injured in combat, according to authorities. This, however, leaves a great many with debilitating injuries, which means new procedures for rehabilitation must be developed.
The press reports the frequency of explosive blast traumatic brain injury (bTBI) as around 40-60% of deployed U.S. combatants. Another report estimates as many as 320,000 or 20% of all forces deployed suffer from some kind of TBI. There is little evidence to support these claims and a comprehensive study of bTBI has yet to occur.
Doctors in Nassau and Suffolk have determined the studies used to gather this data were hampered by limited sample sizes, self-reported data, data gathered from only one center and/or narrow inclusion criteria.
Most importantly, no one really knows the extent of the link between bTBI and post-traumatic stress disorder (PTSD). Both of these separate diseases share common clinical symptoms, which understandably can lead to inaccurate diagnoses. There are a number of organizations even now attempting to uncover the true epidemiology of bTBI, including a comprehensive database effort.