- "Among 105 casualties assessed between June and
October, doctors discovered about two-thirds, or 67 percent, to have brain
injuries."
-
- WASHINGTON -- U.S. casualties
in Iraq may be suffering a greater share of brain injuries than in previous
wars, causing concern among military doctors.
-
- Doctors with the Defense and Veterans Brain Injury Center
at Walter Reed Army Medical Center say early casualty assessments suggest
service members are returning with a wide range of brain injuries ó
from mild concussions to coma or death ó in larger percentages than
the military's rule of thumb.
-
- This suspected rise in an injury notoriously debilitating
to victims and hard for doctors to diagnose may result from the terrorists'
explosive arsenal and vulnerabilities in current U.S. combat gear, according
to experts.
-
- "It's always been well known there are going to
be brain injuries in combat," said Dr. Louis French, a neuropsychologist
and assistant director for clinical services at the brain center. "About
20 percent is usually what's talked about. So far, what we've seen suggests
a higher percentage."
-
- Among 105 casualties assessed between June and October,
doctors discovered about two-thirds, or 67 percent, to have brain injuries,
according to Dr. Laurie Ryan, another neuropsychologist and the assistant
director for research.
-
- The center is pursuing several studies to statistically
verify the trend.
-
- The cause for the dramatic increase seems to be the changed
nature of warfare in Iraq. The terrorists' weapons of choice are high explosives.
Land mines, rocket propelled grenades and improvised bombs allow terrorists
to skirt direct engagement with better trained and equipped soldiers, and
can still inflict damage to soldiers whose torso, or in military jargon
their "center mass", is protected against small arms ballistics.
-
- "There's not as many gunshot wounds," French
bluntly noted.
-
- Ironically, a well-protected body has forced the enemy
to attack the brain, the only organ still vulnerable to deadly attack.
-
- Another leading cause of head injuries is vehicle accidents,
said Ryan, followed by falls.
-
- Although soldiers are wearing head protection, the Kevlar
helmet may not be serving soldiers as a solid defense against modern warfare's
growing threat - concussive impact.
-
- "It's like a pan on your head, held on by shoestring
webbing," said Sgt. Tyler Hall of the 14th Combat Engineers, Fort
Lewis Washington. "The Kevlar is a crude system. When you take a hit,
it rings your head like a bell."
-
- "It's not designed to absorb impact," French
concurred.
-
- Hall has been treated in the center since August, when
a convoy traveling near Tikrit came under attack. Terrorists rigged a 155
mm howitzer shell to detonate in the sand as the convoy drove past. The
explosion blew through the vehicle's bed and tossed Hall. He landed face
down. From the moment he was put on a Blackhawk helicopter until he awoke
at Walter Reed a month later, Hall was in a coma caused by the blunt force
against his head, despite wearing a Kevlar. He's undergone several surgeries
to reconstruct the bones in his face and drain fluid from his brain.
-
- Doctors are treating Hall for several injuries, but it's
the head injury that repeatedly threatened to rob Hall of his life, and
later the ability to appreciate that he still had a life.
-
- "Day to day I'm getting better. A fog is finally
off my eyes. It's frustrating, very frustrating. It's like fighting something
you don't see, no one sees, but you can feel it," said Hall, who's
improved under intense care at the center but still suffers headaches,
nausea, and memory loss. "I still misplace things. I just want to
be able to ride in a car again without getting sick."
-
- French and Ryan said brain injuries add a new element
of difficulty to casualty assessment, because the injuries are challenging
to diagnose and difficult to differentiate from symptoms of other injuries,
for instance the symptoms of psychological stress.
-
- "A blow to the head is known to cause depression.
Anyone who is returning from a situation in which they are being shot at
is likely to experience emotional trauma that can cause depression. It's
hard to draw a line between them," said French. "They share symptoms."
-
- He admits brain injuries may be neglected, or even pushed
aside as merely psychological.
-
- "They are suffering just as much, but may not get
the same support as someone who has an observable injury like a bullet
wound or a broken leg," said French.
-
- Brain injuries can exert themselves in physical, cognitive
or emotional symptoms, and left untreated they can pose significant hurdles
to recovery.
-
- The center is seeking out possible brain injury casualties
instead of waiting for referred patients. Doctors screen each new casualty
list in search of those likely to have experienced concussive impact, like
those in explosions, vehicle accidents or falls. Doctors arrange for personal
interviews with high-risk service members. They've screened over 100 patients
so far, and continue the effort with Walter Reed's approximately 10 daily
arrivals, said Ryan.
-
- The brain center on Walter Reed is the headquarters for
eight different centers, including four veterans' affairs, three military
and a civilian site. The center is congressionally funded. It works hand
in hand, but independently with other medical facilities on Walter Reed.
-
- The center's doctors also are involved in analyzing the
newly developed Modular Integrated Communication Helmet (MICH) for its
protection against impact-related injuries, said Ryan.
-
- The MICH is currently fielded with Rangers, Special Forces,
Navy SEALS, Air Force Special Operations, the Marine reconnaissance community,
the FBI's Hostage Response Team, and a brigade at the 82nd Airborne Division,
according to a MICH project officer.
-
- The padded MICH is the only ballistic helmet used by
Special Operations Command also authorized for use with motorcycles or
other all-terrain vehicles, which the project says attests to improved
impact protection. Lab testing showed a 40 percent improvement in impact
protection over the Kevlar.
-
- The jury is still out on whether the MICH can protect
against the causes of brain injuries faced in Iraq, but there's at least
one soldier voting in favor of dampening the blows landing on our troops'
heads.
-
- "The Kevlar physically moves and bounces on your
head. It's heavy and you hear soldiers complaining about headaches a lot,"
said Hall, running his hand along the back of his head, still laced with
metal sutures. "I'd like to see the Army find something better."
-
- - Spc. Chuck Wagner writes for the Pentagram newspaper
at Fort Myer, Va.
-
- http://www4.army.mil/ocpa/read.php?story_id_key=5445
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