title: Traumatic brain injury in the US military: epidemiology and key clinical and research programs.
abstract: Traumatic brain injury (TBI), and particularly concussion, is a major concern for the U.S. Military because of the associated short term disability, long term cognitive and pain symptoms suffered by some, and risk of prolonged or permanent neurologic injury if the Service member incurs a second TBI before full recovery from the first. Concussions were seen more often during the recent conflicts in Afghanistan and Iraq than in prior conflicts, such as the Vietnam War, because of the use of improvised explosive devices that typically caused non-penetrating closed head injury. Since 2000 more than 300,000 Service members were diagnosed with TBI, of which more than 80 % were concussions. Improved TBI screening tools also have identified a higher than expected incidence of concussions occurring in garrison. In this review we summarize current epidemiologic data for TBI in the Military, and describe contemporary Military procedures and strategies for TBI prevention, identification, evaluation, and acute and chronic care. Key TBI clinical research priorities and programs are described, and innovative organizational plans to address future TBI needs are summarized.
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA. Katherine.m.helmick.civ@mail.mil.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Helmick
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Spells
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA.
authors.forename: Saafan Z
authors.initials: SZ
authors.lastname: Malik
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA.
authors.forename: Cathleen A
authors.initials: CA
authors.lastname: Davies
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA. donald.w.marion.ctr@mail.mil.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Marion
authors.affiliation: DVBIC/DCoE Headquarters, 1335 East West Hwy, Suite 605, Silver Spring, MD, 20910, USA.
authors.forename: Sidney R
authors.initials: SR
authors.lastname: Hinds
mesh_terms: D001930:Brain Injuries / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008889:Military Personnel / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D014481:United States
keywords: Clinical recommendations; Concussion; Department of Defense; Military; Surveillance; Traumatic brain injury