The current conflicts in Iraq and Afghanistan have led to a great many more serious injuries to United States service members. One of the most prevalent and dangerous is explosive blast traumatic brain injury (TBI). Doctors have been studying the rising trend.
There have been a number of military medical treatments for blast TBI which have been a success in the war theater, such as decompressive craniectomy, cerebral angiography, transcranial Doppler, hypertonic resuscitation fluids, and others. There has been similar progress stateside in neurosurgery, neuro-critical care, and rehabilitation for patients suffering injuries caused by blast TBI.
As they continue to treat these injuries, military physicians have been able to clinically categorize many types of blast TBI. One of these important discoveries is the development of psuedoaneurysms and vasospasm in severe blast TBI victims, which can cause delayed decompensation. Another is that mild blast TBI often has very similar clinical features to post-traumatic stress disorder (PTSD). Some physicians have conclude that the injuries explosive trauma causes to the nervous system might be more complex than might appear at first examination.
Scientists in The Bronx and Brooklyn concur with physicians who say more study is needed at both the basic scientific and clinical levels, including detailed biomechanical analysis, so more might be known about the effects of blast TBI. A comprehensive epidemiological study may also be needed to see just how widespread the disease is, and what factors can contribute to explosive blast neurotrauma. It was once considered to be strictly a military concern, but there are signs it is becoming a civilian problem as well.