Because more soldiers in Iraq are surviving severe brain injury, doctors are witnessing a potentially long-lasting set of medical and mental problems unique to participants in modern-day war.
“Traumatic brain injury is the signature wound of this war,” said Lt. Col. Rocco Armonda, an attending neurosurgeon at the National Naval Medical Center in Bethesda, Md.
Armonda and another neurosurgeon treated brain-injured patients for the first year of the war in Iraq. They performed 270 brain surgeries, 60 of which were for penetrating wounds. “In previous conflicts, most of these people would have died,” Armonda said.
In the following year, Armonda said, neurosurgeons doubled the number of craniectomies, in which part of the skull is removed to accommodate brain swelling.
War injuries resulting from brain trauma, according to a report today in the New England Journal of Medicine, range from memory and attention problems to inability to speak and carry out cognitive tasks.
Soldiers are arriving home with headaches and thought disorders, said Dr. Susan Oakie of the journal. They forget words. They may develop new aspects of their personalities and lose aspects of their old selves. With time and therapy, Armonda said, many will recover. But some will have symptoms that never abate.
Oakie points out that Kevlar body armor and helmets have protected soldiers from injuries common to other wars. But these advances are also giving way to unique injuries and symptoms, because in previous wars soldiers did not survive to endure them.
Helmets don’t guarantee protection against impacts that cause brain trauma. A blast can cause symptoms without signs of external injury, Armonda said.
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