BRAIN BUSTERS - From pro football and improvised explosive devices, to vehicle mishaps and falls, traumatic brain injuries are nothing to fool around with

  • Published
  • By DR. HELEN PHIPPS
  • Air Force Emergency Management Branch, Headquarters Air Force Civil Engineer Support Agency
TYNDALL AFB, Fla. --  When former pro football linebacker Junior Seau committed suicide May 2, wide speculation ensued that Seau's demise had been spurred on by head trauma sustained in his violent sport. Seau's death brought national attention to the fate of more than 20 other ex-players, who, after their deaths, were found to have brain damage caused by repeated concussions, which led to depression and other problems.

On Feb. 17 in a suicide eerily similar to Seau's, former Chicago Bears defensive back Dave Duerson shot himself in the chest. Unlike Seau, though, Duerson left a note behind requesting that his brain be examined. Boston University's Center for the Study of Traumatic Encephalopathy examined Duerson's brain and concluded he had, indeed, suffered from head trauma and was diagnosed with a brain disease.

Now comes the scary part. ...

Airmen have something in common with football players.

Imagine yourself in a convoy across Kandahar, Afghanistan. Suddenly, the mine resistant ambush protected vehicle you're in jolts violently, and a flash of light from a roadside improvised explosive device temporarily impedes your vision. As your vision clears you notice the outside of the vehicle is significantly damaged, but the inside is intact and thankfully so are the occupants. ... Or so they seem.

However, if you were able to view a single occupant's organ systems and delve farther into the microscopic world, you would likely see inflammatory proteins skyrocket and trigger cascades of cell death. This is one of many scenarios that may lead to traumatic brain injury.

According to the assistant secretary of Defense, TBI is defined as, "...structural and/or physiological disruption of brain function as a result of external force. ..."

While improvised explosive devices are the primary cause of combat TBI, falls and auto accidents are leading causes of TBI outside of combat. However, the true incidence of mild TBI is difficult to determine since it often goes unreported. Mild TBI is commonly known as concussion and may occur in contact sports such as fighting or football and even non-contact sports such as cycling, cheerleading or skiing.

Most who sustain a concussion recover fully within days to weeks, but it is still important to be evaluated immediately. Since signs and symptoms are not always severe, family and friends often notice changes before the injured person does. This makes it all the more important for everyone to be familiar with the signs and symptoms of concussion.
 
Signs and symptoms immediately after an event that may indicate TBI include headaches with ongoing ringing in the ears, heightened sensitivity to sounds and/or lights, ongoing visual impairment, trouble sleeping, and memory loss.

Our brain cells take longer to recover than most body parts and if severely damaged may not recover at all. Sustaining a second concussion before recovery from the first may lead to more severe symptoms with prolonged recovery, and in rare circumstances can produce diffuse swelling of the brain with dire effects.

Luckily, for those heading to combat zones, the Air Force has policy and procedures in place to develop an individual baseline of wellness and readiness of service members before deployment and after sustaining TBI.

But how can the average person prevent TBI?

Avoid distractions on the road to help lessen the chances of a vehicle mishap. Wear a helmet when riding motorcycles. Athletes may lessen their susceptibility by anticipating hits and bracing for them with stronger muscles.

Some sports teams are using helmets with sensors that notify someone on scene when players sustain a hit likely to cause concussion. However, athletes' desire to compete sometimes outweighs the need to wait until enough time passes to allow for repair. The American Academy of Neurology's position on sports and concussion recommends return to play no earlier than one week for concussions with symptoms lasting longer than 15 minutes and/or any loss of consciousness and a physician evaluation prior to return.

To prevent traumatic brain injury, avoid physical trauma, drive safely, and improve strength, balance, lighting and cleanliness. And if you do suffer physical trauma -- whether in sports, combat, on the road, in recreational activities or from a fall -- watch for symptoms and see a doctor. Don't let things get worse. __________________________________________________________________________________________________________________________________________________________________________ Dr. Phipps provides contract support as a scientist to the Air Force Emergency Management Branch, Headquarters Air Force Civil Engineer Support Agency, Tyndall AFB, Fla. She has a Ph.D. in biomedical science with an emphasis on traumatic brain injury. Maj. Laura Baugh, Air Force Traumatic Brain Injury Program manager, contributed to this article.