The Neuro Cost of War

I highly recommend watching the fabulous Iraq & Back: Bob Woodruff’s Return (or if you’d rather not watch then read it here). It’s an ABC news documentary about the underreported and troubling number of veterans that are returning with traumatic brain injury. Most fascinating is that the reporter for the story is Bob Woodruff himself who suffered from a massive shrapnel blast to the head from an IED. As a result of his injuries, he was in a coma for 36 days and has had a surprising recovery considering the amount of damage in his left hemisphere.

Officially, the Department of Defense says that 1,835 soldiers and Marines have a traumatic brain injury (TBI), but it is likely that many go undiagnosed. When there is a skull fracture or shrapnel penetration then the damage is plain. However, in this new war of protective armor and IEDs often the helmet does it’s job, but the brain is still slammed around violently. In fact, it is estimated that 10% or more of returning soldiers may have sustained an undiagnosed brain injury — that’s at least 150,000 people.

All this is especially troublesome since there is no routine DoD screening procedure, so veterans who think they may have a problem have to apply for neuropsychological testing themselves. Then even if they know they have a problem, it can often be hard to get rehabilitation treatment.

This is compounded by the problem that the effects of the injury may be subtle. Frontal lobe damage can cause shifts in personality or motivation that may not be noticed readily. This is directly connected to the problem with the DoD neglecting troops’ PTSD and other mental health issues.

If you’re interested in reading more about this, Discover magazine had an article about it last month entitled Dead Men Walking. The Smartbrains blog had a post about TBI earlier this month. Relatedly, Dr. J C writes in brainblogger about how most cases of brain trauma are just watchful waiting with the occasional hole drilling to release pressure. We just don’t know enough to do anything else.

Of course, the elephant in the room with all of this is the potential number of Iraqis facing similar problems with even less access to treatment.