In today’s world of advanced technology and weaponry, many of our heroes in the armed forces return home in need of brain injury rehabilitation. In this blog, we focus on defining what exactly traumatic brain injury (TBI) is, how it affects our veterans, and what types of treatment are available.
In recent years, an outcry has arisen for better care for our returning veterans who have been injured in wars overseas. Sometimes, the wounds our warriors have suffered are not easily evident. Armed forces returning with traumatic brain injuries, or TBI, may look, walk, and even act typically. The numbers of our brave men and women returning with TBI has risen in the past 10 years or so from approximately 10,000 in a year to 30,000 in a year (check out the Department of Defense’s Web site). Whether this rise is due to increases in incidence or increases in identification, TBI can be extremely debilitating and demands our attention as a society.
What is traumatic brain injury (TBI)?
Traumatic Brain Injury can occur after any significant, physical damage to the head. This can come in the form of:
- an explosion;
- objects being knocked into the head;
- the impact of slamming a head into an object;
- acceleration and deceleration (back and forth movement) – you might see this in whiplash – when this occurs, the brain actually slams into the skull and continues slam back and forth until the acceleration ceases;
- or a foreign body penetrating the brain.
The common defining symptoms identifying TBI include:
- Lost or decreased level of consciousness
- Loss of memory for events immediately before or after the injury
- Altered mental state at the time of injury (such as being confused, dazed, disoriented, etc.)
- Neurological deficits (such as weakness, loss of balance, sensory loss, loss of movement in limbs, difficulty thinking of works, etc.)
- Intracranial lesion (a lesion within the brain)
TBI is often called “invisible”, because there are often no visible physical symptoms associated
Yet language and cognitive effects of TBI can be intense. Long-lasting symptoms of TBI include physical, cognitive, and behavioral/emotional symptoms. The American Speech Language and Hearing Association summarizes them to include:
- Physical: headache, nausea, vomiting, dizziness, blurred vision, sleep disturbance, weakness, paresis/plegia, sensory loss, spasticity, aphasia, dysphagia, dysarthria, apraxia, balance disorders, disorders of coordination, or seizure disorder.
- Cognitive: problems with attention, concentration, memory, speed of processing, new learning, planning, reasoning, judgment, executive control, self-awareness, language, or abstract thinking.
- Behavioral/emotional: depression, anxiety, agitation, irritability, impulsivity, or aggression.
Traumatic brain injury and the armed forces
TBI is especially difficult to diagnose in our armed forces, as it is often accompanied and complicated by PTSD (post-traumatic stress disorder) and depression, making it difficult to tease apart which symptoms are secondary to TBI and which are secondary to PTSD. Additionally, the symptoms for these three disorders often overlap. In fact, a study in the New England Journal of Medicine, Dr. Hoge and colleagues surveyed 2525 US Army infantry soldiers returning from Iraq. They found that mild TBI in soldiers returning was strongly associated with PTSD and physical health problems for 3 to 4 months after returning home. The group also found that PTSD and depression play a key role in the association between mild TBI and physical health problems.
Brain injury rehabilitation can help
What can we do? We owe our armed forces the best of care and support, especially when they return home as wounded warriors. Speech-Language Pathologists, and apps like Constant Therapy, can assist in improvement of cognitive and language skills affected by TBI. Clinicians and tools like our app can help with reading comprehension, attention, symbol matching, aphasia, memory, executive control, language comprehension, and expressive language.
TBI is not only an affliction of our armed forces – it impacts people here in the United States each and every day as well.