Physicians have long believed that if you hit your head during a car accident or while playing sports, then the concussion symptoms; dizziness, memory loss, headaches, would disappear with a little rest and relaxation. A new study conducted at the University of Oklahoma has suggested that the effects of combat-related traumatic brain injury (TBI) can persist for years without any decreasing severity.
The research study, which was revealed at the annual meeting of the American Headache Society last month, evaluated 500 veterans who battled in the wars in Iraq and Afghanistan. The subjects had screened positive for TBI during deployment between June 2008 and April 2011. The veteran victims were being treated at a special traumatic brain injury department at the Oklahoma City Veteran Affairs Medical Center.
A further level of testing administered to the veterans attempted to evaluate the persistence and intensity of head injury symptoms including depression, lack of coordination, and issues with judgment. As a whole, those symptoms are known as post-concussion syndrome.
Researchers arranged the data according to whether the veterans had sustained a TBI injury within the previous four years, or five to eight years before the screening took place.
The results were discouraging. Not one of the symptoms of post-concussion syndrome seemed to improve over the previous eight years. Almost half of the veterans who had endured a TBI within the past four years disclosed that they were still having mild-to-moderate headache pain. About 46% reported that they were experiencing severe headaches.
Those numbers were nearly identical for veterans who had experienced TBI five to eight years before, with roughly 45 % claiming theywere still having mild headaches and 51% saying they had severe headaches.
The same pattern appeared in the data set for five other symptom types stemming from post-concussion syndrome: dizziness, balance, coordination, decision making and depression. The majority of veterans participating in the study screened positive for all of the symptoms above,excluding depression.
“These results prove we’re not seeing recovery in veterans with these head injuries,” stated Dr. James R. Couch, a respected professor of neurology at the University of Oklahoma and the lead author of the study. “In fact, there is a tendency that things are getting just a little worse.”
Dr. Couch believes closed-head injuries could be particularly dangerous because the veterans with TBI look normal on the exterior, but on the inside are sustaining pain or cognitive problems that can entirely disrupt their normal lifestyles.
He said that the observed symptoms worsened for those veterans who had suffered more than one TBI, suggesting a cumulative impact of head injuries. Previous research has also supported this claim.
Many of the 500 veterans evaluated had received their brain injuries from explosions. However, Dr. Couch stated that the data did not seem to vary significantly with veterans who had TBI from other sources, such as automobile accidents.
The wide range of symptoms associated with TBI contributes to the complexity of treating the injury. Since some symptoms are psychiatric and others physical, numerous medications and therapies are suggested for each. Veterans with post-concussion syndrome may also require additional services to find employment or salvage marriages, Dr. Couch explained.
“We have to recognize that people who may have head injuries may look the same, but they are not going to act the same,” Dr. Couch said. “You’ve got to stabilize the patient’s interaction with family and try to create the best environment for the patient to be able to return to employment, stay with the family and return to self-respect.”
Dr. Couch also noted that the researchers considered the odds that some veterans only reported ongoing symptoms so that they could continue receiving disability compensation.
He termed the above hypothetical occurrence “compensationneurosis,” and said its existence has been debated since the 1880’s, when a German researcher found that the number of people who reported being hurt in railway accidents exponentially increased after the government began to pay out compensation for such injuries. However, Dr. Couch said that there is also sufficient evidence that people generally do not report physical injuries based on whether compensation is involved or not.
A shortcoming of the study, which was partially financed by the Department of Veterans Affairs, was that it was retrospective and did not include follow-ups with the veterans, said Dr. Couch. As a result, events after a deployment, including problems with alcohol or drugs, or even new injuries, were not taken into consideration.
Future research studies should focus on observing a group of veterans with post-concussion syndrome over many years, not only to determine which symptoms persist the longest, but also which therapy treatments are most effective.
Research studies should also observe whether veterans with head injuries develop chronic traumatic encephalopathy, a severe brain disease that was once primarily associated with contact sports but has recently been diagnosed in younger combat veterans.
“Early recognition and early treatment is a major issue here,” he said. “If we treat these people early, we get a much better result.”
Anyone showing signs of moderate or severe TBI should seek medical treatment immediately. Because little can be done to reverse the initial brain damage resulting from trauma, doctors try to first stabilize an individual with TBI and then focus on preventing any further injury. Major concerns include insuring sufficient oxygen supply to the brain and the rest of the body, maintaining blood flow, and controlling blood pressure levels. Imaging tests help in determining the diagnosis and prognosis of a TBI victim. Patients with mild to moderate injuries may receive X-rays to check for bone fractures. For more moderate to severe cases, the imaging test used is a computed tomography (CT) scan. Moderately to severely injured TBI patients also receive rehabilitation that consists of individual treatment plans in the areas of physical therapy, occupational therapy, speech/language therapy, psychiatry, and psychology.
It is extremely important to consult with a qualified Florida traumatic brain injury attorney if you, or a loved one, have sustained a Traumatic Brain Injury (TBI) as the result of another’s negligence. Please contact: [email protected] or call Sibley Dolman Gipe Accident Injury Lawyers, PA at: (727) 451-6900. The brain injury attorneys at the Dolman LawGroup are available for a free consultation and case evaluation.
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