Heads Up Given On Traumatic Brain Injuries
March 4, 2011
- March marks Traumatic Brain Injury Awareness Month, which provides the opportunity to educate Soldiers and the entire community.
- "Our brain does everything. If you don't have your brain working, you're not yourself and you can't do what you do."
- "A person with brain injury is more susceptible to depression, suicide and PTSD."
- "We don't do or say or move or do anything without our brain ... It affects who you are, how you act, how you do your job."
REDSTONE ARSENAL, Ala. -- If not treated, traumatic brain injuries incurred on the battlefield today could cripple large populations of Soldiers decades from now.
"We get a 25-year-old, 30-year-old, they plan to serve another 15 to 20 years, we want to document what's going on now because they're likely to have several more," said Dr. Lynley Ebeling, neuropsychologist and director of Fox Army Health Center's Neuropsychology/Traumatic Brain Injury Clinic. "What's their life going to look like when they turn 60 and 70' This could be that now we're dealing with them, but come 70, you're going to have a whole group of Soldiers who are cognitively impaired. It's not just that it shows up right now and goes away, there's evidence that it could show up as you get older, as the brain ages, and now suddenly it's not aging properly, it's accelerated."
March marks Traumatic Brain Injury Awareness Month, which provides the opportunity for Ebeling to educate not just the Soldiers she sees, but the entire community, on the ways a brain injury can affect how a person thinks, reasons and remembers.
"It's an important area that people have previously minimized, and it's not something to minimize," Ebeling said. "Our brain does everything. If you don't have your brain working, you're not yourself and you can't do what you do."
Symptoms of a traumatic brain injury include blurred vision, headaches, ringing in the ears, irritability, trouble with memory, attention or concentration and slowed thinking, as well as feeling easily confused; symptoms that can remain with an individual for decades, or not manifest until they age. Leading causes of TBI in the military include blasts, fragments, bullets, falls and motor vehicle crashes, but in civilian life, concussions occur in more everyday activities, such as sports.
Every 23 seconds, someone in the United States suffers from a traumatic brain injury, according to the Brain Injury Association of America, making it a community-wide concern.
"This is an area that a lot of people don't know anything about, but it's also an area where if you were to ask any single person, they can relate and remember that they've had a concussion sometime in their life," Ebeling said. "It's so prevalent out there, but yet people have no idea what a concussion is, what it means, how you treat it, how you prevent it from snowballing into something significant."
Traumatic brain injury occurs when the head is hit or violently shaken, resulting in either a loss of consciousness or an alteration of consciousness, in which an individual may become dazed and confused or see stars. An individual does not have to lose consciousness to experience a traumatic brain injury, Ebeling said.
Fox's Traumatic Brain Injury Clinic serves as a regional TBI center for active duty Soldiers located not only at Redstone Arsenal, but also at Fort Sill, Okla., Fort Rucker, Ala., and Fort Campbell, Ky., as well as Alabama's CWBTU, a relationship made easier thanks to video conferencing which allows Ebeling to treat Soldiers where they are located. Since first opening in 2008, Ebeling and TBI case manager Tim Elmore have seen between 300 and 400 Soldiers, around 200 of which have been tested cognitively, checking IQ, academic functioning, memory and other thinking skills, to determine whether or not they were functioning at a level expected of a person without a traumatic brain injury.
"The top issues in the Army are the excessive amount of concussions, PTSD and suicides," Ebeling said. "A person with brain injury is more susceptible to depression, suicide and PTSD, so it kind of works together. About 20 to 30 percent of Soldiers coming back from war meet criteria for having had a concussion, so it's a huge amount."
Ebeling typically spends between 12 and 14 hours with each patient, interviewing, testing and analyzing them to determine a diagnosis and treatment plan. Her assessment of each Soldier helps clarify the diagnosis and identify what is really going on in the brain, whether it is a physical or psychological problem, to develop the best course for treatment.
Unfortunately, for many Soldiers returning home from war, the symptoms of TBI are very similar to PTSD and the emotions that accompany the return home from a deployment, often making it difficult for an individual or their family members to determine what the real cause of the symptoms are. Irritability, headaches and memory problems overlap between the two. An individual with PTSD will suffer from flashbacks, whereas someone with a concussion won't; those with PTSD will avoid situations that trigger their memories, whereas someone with a concussion will not; and while a person with a concussion can't sleep because they're restless, someone with PTSD won't be able to sleep due to night terrors.
"A lot of the time it's tackling depression, PTSD and concussions all at once and trying to sort out the treatment for that," Ebeling said.
Rehabilitation for brain injury includes getting seven to eight hours of sleep each night, writing things down to help remember things, avoiding alcohol, tobacco and excessive caffeine, sticking to a routine, staying both mentally and physically active, as well as avoiding further head injury. Soldiers may experience a TBI while deployed, but may need to overlook the injury due to being in combat or other factors. It isn't "until they come back home and they realize that they are different," Ebeling said. "They can't do the normal cognitive things that most people do."
The damage a TBI does to an individual's brain has been found to increase as the number of concussions they experience increases, according to Ebeling, which makes it vital for a person to do everything they can to avoid further head injury, if at all possible.
"TBI, if it ends up being mild to moderate and you've had multiple concussions, you could end up with permanent injury where the person is permanently forgetful, permanently these headaches just don't quit, permanently distracted and permanently short tempered," Ebeling said. "When you kill neurons in the brain it changes who you are. We are our brain. We don't do or say or move or do anything without our brain. If you compromise that it affects who you are, how you act, how you do your job."
The neuropsychology/TBI clinic currently only serves active duty Soldiers, and is located in the behavioral medicine division at Fox. To schedule an appointment, call 955-8888, ext. 1032 or 1940.