After the Boom, the Complexity of Blast Induced Traumatic Brain Injury (TBI) - Effects of Improvised Explosive Devices (IEDs), Neurological Impairments, Recoilless Rifle, Helmet and Soldier Protection

Traumatic Brain Injury (TBI) has become a major health concern in the U.S. Army. Since October 2001, over 2.6 million service members have deployed in support of combat operations, where TBI, primarily caused by blast, has been underreported and underdiagnosed. The Department of Defense (DoD) reports that nearly 384,000 service members serving in the Global War on Terror have suffered a TBI, classifying eighty two percent as mild TBI (mTBI). Labeled an "invisible wound," mTBI has proven difficult to both prevent and diagnose. In addition, blast injuries further complicate mTBI diagnosis, adding to the problem's complexity. In this light, protecting soldiers from blast-induced TBI (bTBI) has attracted attention from the public, senior DoD officials, and the government. The DoD has funded studies to help medical professionals diagnose bTBI and help identify its associated effects in order to treat those injured and return them to service. As the Army races to test and field new equipment to better protect soldiers, diagnosing mTBI, especially those induced by blast, remains a problem for health professionals and the Army at large. Thus, further research is needed that will spark new strategies to help alleviate blast-induced brain injuries and their ramifications in soldier's lives.This compilation also includes a reproduction of the 2019 Worldwide Threat Assessment of the U.S. Intelligence Community.1. Introduction * Background: TBI Defined * Background: History of TBI * Literature Review * Methodology * 2. Department of Defense (DoD) Milestones * Incremental improvements since 2005 * TBI screening * Blast Physics * Neurological Impairments * Mechanism for Blast Transport * Three possible pathways to the brain * Theories of how blast-induced brain damage occurs * Causes include the recoilless rifle * 3. Distinctive bTBI Characteristics * bTBI and Disease Risk * bTBI injuries correlate with incidents of PTSD * Combat MOSs show disproportional rates of mTBI * Blood test helps identify TBI * Prognosis and Recovery * 4. Treatment for TBI * TBI and Long-Term Health or Disability Outcomes * Challenges and Issues * Soldier Protection from Blast * Combat helmet improvements * Development of robotic teammates * 5. Analysis and Recommendations * Analysis * RecommendationsFor hundreds of thousands of soldiers who have served in the U.S. Army since the beginning of the Global War on Terror (GWOT), the likelihood of suffering a Traumatic Brain Injury (TBI) during active duty has changed from a statistical possibility to a personal, often life-changing reality. Since October 2001, over two million service members have deployed in support of combat operations in Iraq, Afghanistan, and Syria; of those, studies show that up to twenty-three percent - or more than 380,000 - have suffered a TBI of some degree or category. As mounting health issues have accompanied service members returning home, concern from soldier's loved ones, the medical community, and U.S. governmental agencies has risen as well. In response, independent study groups, task forces, and a Presidential Commission in 2012 were formed to study the effects of TBI and make recommendations.