Report sees long-term problems for troops who suffer traumatic brain injuries

Traumatic brain injuries, one of the signature injuries of the wars in Iraq and Afghanistan, can be linked to such long-term problems as seizures, aggression and dementia reminiscent of Alzheimer's disease, according to an Institute of Medicine report released today.

Even mild brain injuries, the report found, appear to be associated with some of these outcomes.

The report is a wake-up call, said Dr. Michael Yochelson, who specializes in traumatic brain injury at National Rehabilitation Hospital in Washington, and used to work at the National Naval Medical Center.

"We need to be prepared to take care of these people, and we need to be observant," said Yochelson, who was not involved in the institute's report.

A recent Rand Corp. report, which Yochelson worked on, estimated that 19% of the troops returning from Iraq and Afghanistan, or more than 300,000 people, have come back with traumatic brain injuries. It estimated that treatments for such injuries and the loss in productivity have cost the nation, conservatively, about $554 million.

Traumatic brain injuries occur in a wide variety of ways, both predictable and unexpected -- gunshot or shrapnel wounds, strikes to the head or even exposure to an energy source. The brain can be harmed even when a person does not lose consciousness, doctors said.

The report by the nonprofit Institute of Medicine was the latest installment in a series of studies commissioned by the Department of Veterans Affairs on the health of veterans from the Gulf War and current conflicts.

The study was intended to aid VA officials in understanding what other conditions they should look out for in brain-injured patients and in determining disability benefits, said Dr. George W. Rutherford, chairman of the committee that wrote the report.

The authors reviewed 1,900 studies on traumatic brain injuries, looking for problems that persisted more than six months. Most of the research focused on civilians.

The report showed a "big hole" in medical knowledge about blast injuries, which have only recently come to doctors' attention because they are hallmarks of the Iraq and Afghanistan wars, Rutherford said.

"The good news is [that service members] are surviving injuries they had not survived in the past," Rutherford said. "The bad news is, since they didn't survive in previous conflicts, we don't have a lot of background experience."