Cognitive Rehabilitation for Mild Traumatic Brain Injury
Rept. for 27-28 Apr 2009
DEFENSE CENTER OF EXCELLENCE FOR PSYCHOLOGICAL HEALTH AND TRAUMATIC BRAIN INJURY ROSSLYN VA
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Mild traumatic brain injury mTBI, also known as concussion, is one of the invisible injuries of the current conflicts in Afghanistan and Iraq. The true incidence of military mTBI is unknown. This is similar to the civilian sector as some individuals with mTBI do not seek medical care or are not properly diagnosed. However, of the combat exposed U.S. military personnel who have served in Afghanistan and Iraq since 2001, there is a 15-22 mTBI incidence rate by self report Hoge et al., 2008, Terrio et al., 2009. In the mTBI literature, it is reported that a substantial majority of civilian patients with mTBI 75-90 have symptoms that are transient and self-limiting, with apparent full recovery occurring within minutes to several weeks following injury Levin et al., 1997. However, approximately 5-15 of persons with mTBI do not show the expected rapid and uneventful recovery and have persistent symptoms andor functional limitations Iverson et al., 2006 Ruff et al., 1996. Given the incidence of mTBI in the military, and the suspected high frequency of repeated mTBI, this percentage may represent a substantial number of warriors. Differences exist between military and civilian populations regarding mTBI. There is no evidence to determine if the recovery trajectory for mTBI sustained in combat replicates that of the civilian cohort. Additionally, the high incidence of blast-related mTBI as well as the psychologically traumatic component of the source of the wartime injuries further complicates comparisons to civilians. Thus, it is possible that the number of patients with persistent symptoms is greater than 5 of all those sustaining mTBI in the military population.
- Medicine and Medical Research