FORT HUACHUCA, Arizona -- March is designated as Brain Injury Awareness Month to demonstrate the commitment of the Department of Defense and Department of Veterans Affairs to raise awareness about traumatic brain injury and to educate and provide resources about brain injuries to service members, veterans, family members and health care professionals.

The Defense and Veterans Brain Injury Center encourages everyone to think about what you are doing and how you can be safe to avoid getting a TBI (for example, always wear a helmet when riding a bicycle or motorcycle).

Also, learn the signs and symptoms of TBI/concussion and when to get checked out. Then, see your Primary Care Provider or nearest emergency room as soon as possible after a head injury, and follow your provider's recommendations for rehabilitation to ensure optimal recovery.

The Department of Defense's definition of TBI is a disruption of brain function resulting from a blow or jolt to the head or a penetrating head injury indicated by new onset or worsening of at least one of the following: loss of consciousness, alteration of consciousness, post-traumatic amnesia, neurological deficits, or a intracranial lesion. However, not all blows or jolts to the head result in a TBI.

According to the Centers for Disease Control and Prevention, TBIs are a contributing factor to about 30 percent of all injury-related deaths in the United States and a substantial number of cases of permanent disability, within the general population.

The leading causes of TBI are falls, unintentional blunt trauma, motor vehicle accidents and assaults. Falls are the number one cause of TBI, accounting for 40 percent of all TBIs in the United States that resulted in an emergency room visit, hospitalization or death.

More than half (55 percent) of the TBIs among children 0 to 14 years were caused by falls, and more than two-thirds (81 percent) of TBIs in adults aged 65 and older are caused by falls.

Unintentional blunt trauma (e.g., being hit by an object) accounts for about 15 percent of TBIs in the United States. Motor vehicle accidents account for about 14 percent of TBIs.

Assaults account for about 10 percent of all TBIs, and about 75 percent of those occurring in people between 15 to 44 years of age.

Traumatic brain injury has been called the "signature wound" of the wars in Iraq and Afghanistan. Injuries service members receive downrange can originate from improvised explosive devices, rocket-propelled grenades, mortars, gun blasts, falls and equipment failure. Many military personnel have experienced multiple deployments due to the length of war, translating into multiple exposures to potential TBI events.

However, more than 80 percent of TBIs occur in garrison. Common causes of a TBI can include a blow to the head during sports and recreational activities, combatives and other military training, as well as vehicle/motorcycle accidents, and falls.

The Defense and Veterans Brain Injury Center continues to track the total number of service members throughout DOD who have been diagnosed with a TBI. From 2000-2016 (Q1-Q3), there have been 357,048 service members diagnosed with a TBI within garrison and the deployed setting. Soldiers account for 58 percent of all these service members diagnosed with a TBI.

Most of these cases (82.3 percent) have been classified as a mild TBI (mTBI). An mTBI is also known as a concussion. The majority of these service members are expected to have a full recovery within a few days up to a few months. Symptoms presenting outside of this timeframe may also be associated with inadequate sleep, chronic pain, or other behavioral health issues that share common symptoms of mild TBI. Evaluations seek to identify and treat symptoms with the expectation that service members will fully recover and continue to work within their military occupational specialty.
Fort Huachuca is home to a Level 4 TBI Program, providing outpatient care to service members with mild traumatic brain injuries occurring while deployed and in garrison. RWBAHC TBI team members consist of Dr. Richard LaMacchia, treating neuropsychologist; Tracey-Jean Santoro, psychology technician; and Philip Sloss, registered nurse case manager.

The mission of the TBI Team is to assess and evaluate physical, cognitive, emotional and behavioral symptoms in order to optimize care, improve outcomes and reduce disability using a patient-centered approach to promote recovery.

Early identification of symptoms and treatment are important in preventing long-term consequences of concussion/TBI. Service members can self-refer, or be referred to the TBI Program by their primary care manager or another health care provider. An accurate history is then obtained by detailing the injury event(s) and reviewing the service member's medical history and symptoms.
At Fort Huachuca, although a few of these service members may be referred immediately following a potentially concussive event, most come to the RWBAHC TBI Program after continuing to experience symptoms possibly related to a traumatic brain injury that occurred in the past.

Typical symptoms include headaches, short-term memory problems, irritability, difficulty sleeping, problems with balance, vision or hearing, reduced attention and concentration, and other cognitive problems. Service members may also have post-traumatic stress disorder, which has many overlapping symptoms with TBI. This often requires both conditions to be addressed simultaneously.
The TBI Team develops an individual plan of care for each service member that ensures he or she will receive the highest quality care in a timely and efficient manner. The plan of care developed is unique to each individual, and the process of achieving goals set forth in the plan of care may take a few months or a longer period of time.

Typical treatment goals include reduction of headache frequency and intensity, improved onset and length of sleep, improved short-term memory and cognitive functioning, improved balance, vision, hearing and reduction of PTSD symptoms.

The TBI team works with a variety of disciplines both within RWBAHC as well as in the community setting, including Physical Therapy, Occupational Therapy, Speech Therapy, Optometry, Behavioral Health, Neurology, sleep assessments and Audiology.

The TBI Team is available 7:30 a.m.-4:30 p.m. Monday through Friday. Call 520.533.5756 if you would like more information about the TBI Program.