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Traumatic brain injuries: An issue both on the battlefield and the playing field

Traumatic brain injuries: An issue both on the battlefield and the playing field

Last week I had the distinct honor of caring for a wounded veteran who suffered a traumatic brain injury (TBI) while handling munitions. He was literally using his hands to move large mortars when one of them unexpectedly discharged. The explosion left him blind and with significant facial injuries, including a big hole in the base of his skull. The procedure included the concerted efforts of three different surgical specialties designed to reconstruct the bones of his face and skull, to provide symmetry, and improve facial function and protect his brain. Like a true solider, he recovered quickly, and returned to the Palo Alto Veterans Hospital to continue on his path down rehabilitation road.

America’s soldiers aren’t the only ones suffering from TBI. Brain injuries are one of the largest growing ailments faced by our civilian community

Sadly, I’ve told this story before, with the many other soldiers I’ve cared for. Over the last decade of intense war, nearly 260,000 American military service members have suffered a traumatic brain injury. The U.S. Department of Veterans Affairs (VA) and Department of Defense (DOD) have worked tirelessly to identify and treat our nation’s troops, and it’s helping. There are concussion restoration centers in Afghanistan, and neurologists, neurosurgeons and psychiatrists serving in the warzone; and every VA location around the country has, or is in the process of setting up, a mental health center of excellence. Troops who suffer from TBI in combat are quickly evaluated, identified and treated. It’s often said the only good thing that comes out of war is the advancement of medicine, and from these past ten years we have begun to understand the impacts of brain injury.

America’s soldiers aren’t the only ones suffering from TBI. Brain injuries, such as traumatic brain injury, stroke, or damage caused by brain tumors, are one of the largest growing ailments faced by our civilian community. Parents know this better than anyone else: Kids hit their heads – and they do so frequently. Whether it’s sports or just kids being kids, the rate of brain injury is on the rise. Surprisingly, after football, girls’ soccer is the next leading cause of concussions.

Tonight on PBS, Frontline will release a long-awaited documentary detailing the impact of concussions as they relate to American’s most popular sport, football. (The program will air locally on KQED at 9 PM.) The investigation into the National Football League aside, “League of Denial” is poised to expose the long-term effects of repetitive and severe head injuries, an awareness that America needs now. The early onset dementia, increased rate of suicide, and depression are all being examined as potential consequences of brain injury – and football is a big source of injuries. I expect that the game will evolve, and new rules will be implemented to improve safety – but the changes have to come from fans, supporters, and players.

And what about the American public? Where are the concussion restoration centers for the 1.7 million Americans who suffered a concussion this year alone? Well, the short answer is: They’re likely coming. As the recent announcement by the president of the $100 million BRAIN Initiative indicates, concussions are an important issue to us as a nation. And with the growing frequency of neurologic illnesses like Alzheimer’s, Parkinson’s, dementia and brain injury, now’s the time for us to figure out how to prevent, diagnose, and treat them.

Anand Veeravagu, MD, (@AnandMed) is a senior neurosurgery resident at Stanford and a former White House fellow/special assistant to Secretary of Defense Hagel.  Anand’s interests include complex spinal deformity, advanced brain tumor molecular imaging, and patient centered outcomes analysis.

Previously: NIH announces focus of funding for BRAIN initiative, Developing a computer model to better diagnose brain damage, concussionsStanford researchers working to combat concussions in footballMental and emotional costs of a concussionA conversation with Daniel Garza about football and concussionsDeceased athletes’ brains reveal the effects of head injuries and When can athletes return to play? Stanford researchers provide guidance

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