title: The Natural History of Acute Recovery of Blast-Induced Mild Traumatic Brain Injury: A Case Series During War.
abstract: Traumatic brain injury (TBI) secondary to blast exposure is a common injury in the Global War on Terrorism, but little is known about the acute effects, recovery, pathophysiology, and neuropathology of blast-induced mild TBI (mTBI) in humans in a battlefield environment. Moreover, there is ongoing debate whether blast-induced mTBI is a different injury with a unique pathophysiology compared with mTBI from blunt trauma. In the case series reported here from Craig Joint Theater Hospital at Bagram Airfield, Afghanistan, 15 military service members with acute concussion/mTBI associated with blast exposure were evaluated within the first 24 hours after concussion and on days 2, 3, 5, and 7 with a Graded Symptom Checklist and a balance assessment, the Balance Error Scoring System. These data suggest that the recovery in blast-induced mTBI follows the pattern of recovery in sports-related concussion reported in The National Collegiate Athletic Association Concussion Study. In this retrospective case series, we provide the first description of the natural history of acute recovery in blast-induced mTBI, and we suspect, given our experience treating military service members, that further observations of the natural history of recovery in blast-induced mTBI will continue to mirror the natural history of recovery in sports concussion.
authors.affiliation: Occupational Therapy Clinic, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859.
authors.forename: David T
authors.initials: DT
authors.lastname: Larres
authors.affiliation: Department of Behavioral Biology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Walter
authors.initials: W
authors.lastname: Carr
authors.affiliation: Occupational Therapy, Guthrie Army Health Clinic, 11050 Mount Belvedere Boulevard, Fort Drum, NY 13602.
authors.forename: Elizandro G
authors.initials: EG
authors.lastname: Gonzales
authors.affiliation: Department of Neurology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Hawley
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D001265:Athletic Injuries / Q000534:rehabilitation*; D001924:Brain Concussion / Q000150:complications / Q000534:rehabilitation*; D001930:Brain Injuries / Q000503:physiopathology; D000070625:Brain Injuries, Diffuse / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D012189:Retrospective Studies