Effects of Concussions in Military Deployment and Training

Running Head: EFFECTS OF CONCUSSIONS SUSTAINED DURING MILITARY
DEPLOYMENT AND TRAINING
Effects of concussions sustained during military deployment and training
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EFFECTS OF CONCUSSIONS SUSTAINED DURING MILITARY DEPLOYMENT AND
TRAINING 2
Executive summary
Scientists are still trying to link the enduring effects of mild brain injury to relate chronic or
neurodegenerative problems. Despite the advancement in technology in terms of weapons and body
armor, the brain remains vulnerable to non-penetrating injuries such as extreme impacts on the
head and explosions during combat. The major challenge of diagnosing concussion with technology
is that there is no specific subsystem of the brain that is universally affected by the concussion. Early
diagnosis of a concussion remains a priority in order to prescribe the suitable therapeutic
management and deterrence of premature deployment to battle zones.

EFFECTS OF CONCUSSIONS SUSTAINED DURING MILITARY DEPLOYMENT AND
TRAINING 3
Introduction
The Committee on Head Injury Nomenclature of the Congress of Neurological Surgeons
(1966) explains concussion as, “a clinical syndrome characterized by the immediate and transient
posttraumatic impairment of neural function such as alteration of consciousness, disturbance of
vision or equilibrium, etc. due to brain stem involvement.” Later the American Academy in
Neurology (AAN) (1997) referred to concussion as “any trauma-induced alteration in the mental
status that may or may not include the loss of consciousness.” The First International Symposium on
Concussion in Sports in Vienna described concussion as a “complex pathophysiological process
affecting the brain, induced by traumatic biomechanical forces (2001).”
Concussion may be as a result of direct hit by a blunt object to the skull, neck, or face, or any
other part of the physique that in turns conveys a spontaneous force to the brain. The concussion
leads to neuropathological changes in the brain however, the impact is mainly manifested in the
functional capacity of the brain other than any structural changes in the head. There may not
necessarily be loss of consciousness registered after the concussion as the clinical and cognitive
symptoms will resolve sequentially (Giza & Hovda, 2001).
Barr, et al. (2008) states the effects of concussion as having compromised cognitive
functionality, reduced stability, and subjective post-concussive symptoms. A study on the impact of
concussion conducted on college football players revealed that players suffering from concussion
showed 85.2% complained of headaches, 77% had balance problems, and 69.4% reported feeling of
reduced cognitive function at the time of the accident. The evidence from the research suggested
that players suffering from subjective post concussive grievances and empirically evaluated cognitive
function impairment and stability related issues tend to recover fast from the injury, balance issues
are sorted within five days, full cognitive functions resume functionality within a week of the injury.
Traumatic brain injury (TBI) is prevalent in the U.S. military. Research by the Defense and
Veterans Brain Injury Center (DVBIC) indicates that between 2000 and 2011, 220, 430 soldiers had
suffered from Traumatic Brain Injury (TBI) of which 169,209 of these cases were classified as
concussions. However, just like in civilians, concussion might be problematic to detect and can be
perplexing to manage. This is because during standard imaging it shows no abnormalities, moreover;
both signs and symptoms of concussion are subtle (Iverson, Langlois, McCrea, & Kelly, 2009; Ling,
Bandak, Armonda, Grant, & Ecklund, 2009).
As of 2003, there were approximately 300,000 cases of concussion related to sports
reported. This number however is believed to be an understatement as many of the cases go
unreported or due to the lack of awareness of the constituents of concussive symptoms. However,
the cognitive functions of the athletes after a concussion are what are employed to determine the
suitability to return to play and the various rehabilitation strategies (Aubry, et al., 2002). The normal
procedure or established protocol of evaluating the cognitive functions of the brain after a
concussion is the short battery of Neuropsychological Test. This compares the performance of the
athlete pre-concussion period and post-concussion period. The scores between the two periods are
what are used to speak of the mental status during the post-concussion period. Nevertheless, this
method has gained considerable attention with many raising issues regarding the methodology
itself. Issues raised involve the setting in which the test occurs and the potential effect of other
factors such as age and learning difficulty has on the results of the NP test (Duhaime, et al., 2012;
Barr, McCrea, & Randolph, 2008; Giza & Hovda, 2001).