Traumatic brain injury: "Signature wound"

Traumatic brain injury is accounting for an alarming percentage of American casualties in Iraq. According to a recent paper in the New England Journal of Medicine, up to 60 percent of wounded American soldiers have sustained brain damage.

Update:

The meticulous and diligent Revere followed up on the 60% statistic. Turns out that traumatic brain injuries only account for about 30% of total casualties:

I have put the following Clarification on Effect Measure regarding Newsday's proportion of 60% TBI in returning injured Iraq war soldiers:

Clarification, 1:57 pm, 5/25/05: I have gone back to check the figures in the NEJM paper, as I was bothered by the 60% figure in the Newsday quote, above. The 60% figure does appear in the NEJM article (actually it is 59%) but refers specifically to admitted patients exposed to a blast (as from an IED). The best data I can find on the proportion of injuries due to blast suggests it is about 50%. Thus the proportion of all injuries with TBI would seem to be 30%, still a horrendous figure. We apologize for the lack of clarity here, for which we take responsibility.

Comments

[Njorl]

I don't think alarming is the right word. It is not surprising. Use of body armor decreases the injuries to other parts of the body, and improvements in medevac'ing and brain surgery improve survival from head wounds. Hopefully the VA is looking ahead and planning for this.

[mudkitty]

The budget for the VA has been cut by Bush. So much for "hopefully."

[LCGillies]

One reason for this is the fact that Humvees are being "armorer" with welded scrap, like some kind of pathetic found art object. See http://bigbalagan.typepad.com/big_balagan/2005/04/support_our_tro.html.
Basically, the fake armor never comes high enough to cover heads. If the general public only knew what our soldiers have been dealing with for the past two years...SNAFU.

[Revere]

I have put the following Clarification on Effect Measure regarding Newsday's proportion of 60% TBI in returning injured Iraq war soldiers:

Clarification, 1:57 pm, 5/25/05: I have gone back to check the figures in the NEJM paper, as I was bothered by the 60% figure in the Newsday quote, above. The 60% figure does appear in the NEJM article (actually it is 59%) but refers specifically to admitted patients exposed to a blast (as from an IED). The best data I can find on the proportion of injuries due to blast suggests it is about 50%. Thus the proportion of all injuries with TBI would seem to be 30%, still a horrendous figure. We apologize for the lack of clarity here, for which we take responsibility.

[Snarky]

Well, this just goes to show that soldiers are actually representative of the population at large, who have easily proven themselves brain damaged.

[Flint]

Snarky...

Black humor... funny... but very dark!

[Lebo, RN]

At the traumatic brain injury conference I recently attended in Seattle, the number of references to incoming TBI cases due to Iraq numbered in the zeroes.
Cross reference on the topic: Tom Cruise's appearance on Oprah. Me thinks he has suffered some reptilian amygdala injury.

[Flint]

USAToday posted this, honest mistake if you read the article quickly:

"To identify cases of TBI, doctors at Walter Reed screened every arriving servicemember wounded in an explosion, along with those hurt in Iraq or Afghanistan in a vehicle accident or fall, or by a gunshot wound to the face, neck or head. They found TBI in about 60% of the cases. The largest group was 21-year-olds. (Related story: Survivors struggle to regain control)"

"From January 2003 to this January, 437 cases of TBI were diagnosed among wounded soldiers at the Army hospital, Lux says. Slightly more than half had permanent brain damage. Similar TBI screening began in August at National Naval Medical Center in Bethesda, Md., near Washington. It showed 83% — or 97 wounded Marines and sailors — with temporary or permanent brain damage. Forty-seven cases of moderate to severe TBI were identified earlier in the year."

"The wound may come to characterize this war, much the way illnesses from Agent Orange typified the Vietnam War, doctors say. "The numbers make it a serious problem," Lux says."

http://www.usatoday.com/news/nation/2005-03-03-brain-trauma-lede_x.htm

[cm]

For all of those.

When I was a young man I carried my pack
And I lived the free life of a rover
From the Murrays green basin to the dusty outback
I waltzed my Matilda all over
Then in nineteen fifteen my country said Son
It's time to stop rambling 'cause there's work to be done
So they gave me a tin hat and they gave me a gun
And they sent me away to the war
And the band played Waltzing Matilda
As we sailed away from the quay
And amidst all the tears and the shouts and the cheers
We sailed off to Gallipoli

How well I remember that terrible day
How the blood stained the sand and the water
And how in that hell that they called Suvla Bay
We were butchered like lambs at the slaughter
Johnny Turk he was ready, he primed himself well
He chased us with bullets, he rained us with shells
And in five minutes flat he'd blown us all to hell
Nearly blew us right back to Australia
But the band played Waltzing Matilda
As we stopped to bury our slain
We buried ours and the Turks buried theirs
Then we started all over again

Now those that were left, well we tried to survive
In a mad world of blood, death and fire
And for ten weary weeks I kept myself alive
But around me the corpses piled higher
Then a big Turkish shell knocked me arse over tit
And when I woke up in my hospital bed
And saw what it had done, I wished I was dead
Never knew there were worse things than dying
For no more I'll go waltzing Matilda
All around the green bush far and near
For to hump tent and pegs, a man needs two legs
No more waltzing Matilda for me

So they collected the cripples, the wounded, the maimed
And they shipped us back home to Australia
The armless, the legless, the blind, the insane
Those proud wounded heroes of Suvla
And as our ship pulled into Circular Quay
I looked at the place where my legs used to be
And thank Christ there was nobody waiting for me
To grieve and to mourn and to pity
And the band played Waltzing Matilda
As they carried us down the gangway
But nobody cheered, they just stood and stared
Then turned all their faces away

And now every April I sit on my porch
And I watch the parade pass before me
And I watch my old comrades, how proudly they march
Reliving old dreams of past glory
And the old men march slowly, all bent, stiff and sore
The forgotten heroes from a forgotten war
And the young people ask, "What are they marching for?"
And I ask myself the same question
And the band plays Waltzing Matilda
And the old men answer to the call
But year after year their numbers get fewer
Some day no one will march there at all

Waltzing Matilda, Waltzing Matilda
Who'll come a waltzing Matilda with me
And their ghosts may be heard as you pass the Billabong
Who'll come-a-waltzing Matilda with me?

[Bob]

I believe the 'Waltzing Matilda' lyrics are missing a line crediting Eric Bogle as the author.

http://www.anu.edu.au/people/Roger.Clarke/WM/Bogle.html

[sean]

This is similar to our society in that we are all "safe" now. But, our enemies keep trying to blow up our heads (minds). We do this to ourselves. The skull protects the head for a reason. THINK. well.

we don't belong over there.

[Geo Gosling]

I survived a bicycle (me) vs pick-up truck (them) collision in 1995. I received a TBI and was in the hospital for 14 weeks. I was 25 years old at the time. I have written a book about the whole thing (so far) entitled, "TBI Hell - A traumatic Brain Injury really Sucks." I have gotten good reviews from other TBI sufferers who have read the book. I tell it like it is and I don't sugar-coat anything. It's unlike any other TBI book that I am familiar with.