Traumatic Brain Injury (TBI) is a “signature” wound of the current conflicts, yet it is often difficult to diagnosis and understand in many cases. We hope to give you a brief overview of TBI and then suggest that you explore it further at some of the websites listed.
Bottom Line, Up-Front
Currently, there are three main classifications of Traumatic Brain Injury. They are mild, moderate and severe. There are few resources for accurately diagnosing TBI. The most clear diagnosis is for severe TBI. Often, with severe TBI, there are tests like MRI’s and fMRI’s that can obtain a “picture” of the brain. In severe TBI, it is most often possible to see from those “pictures” where specific damage has been done. Sometimes this is possible for moderate TBI and sometimes it is not. Very often, it is not possible to get a “picture” with mild TBI. In those cases, it is often up to some of the following assessments to help determine if there is a brain injury:
1) A Neurological-Psychological Evaluation (sometimes called a Neuro-Psych eval). This requires a qualified Neuro Psychologist to perform a series of tests on the patient that help to determine if there has been injury to specific parts of the brain and to determine the severity. These tests are NOT medical tests, but a series of memory, motor, and other tests that can take at least a full day (and often more) to perform. Then, it may take up to a month or more for the psychologist to prepare a report that offers a diagnosis.
2) A “self” evaluation. This could be an on-line test or even a test given in the post-deployment phase in which the veteran is asked questions like, “did you loose consciousness due to a blast” or “do you have severe and debilitating headaches that began after being around a blast”. The results of those evaluations are only as good as the veterans’ memory or willingness to answer honestly.
3) Observation by others. Sometimes other people notice things that a veteran may not. They may recognize that the veteran acts differently and/or processes information differently than before deployment. Often times, veterans do not remember or are unaware or unwilling for a variety of reasons, to admit that their thinking, seeing, judgment, and behavior have changed, but many times the people like family and friends may notice a change.
At one time, there was an effort on the part of researchers to take brain scans before a service member left for deployment, and then when the veteran returned to have a “before” and “after” view of the brain to understand if there had been brain injury. To our knowledge, this has NOT been implemented on a consistent nor wide scale basis.
Then, there was a discussion about doing research on specific blood tests that may reveal if a veteran had TBI. At this time, we are not aware of the results of this research and/or how the results may be used to assist our current veterans home.
Sadly, sometimes brain injury can come from inappropriate use of medications. Whether these medications are pharmaceutical or not, if you notice a difference in the way your brain “feels”, then it is important to speak with your care team. It is extremely important that you voice these concerns and that your care team listen. Honest communication that results in an effort to care for the concerns in a timely and compassionate way are the best way to avoid long term problems.
At one time, there was a belief that brain injuries sustained more permanent challenges. Now, there is a belief that with correct diagnosis and good treatment (PROPER medication if prescribed and monitored carefully AND brain exercises and other methods) can create wonderful options for healing. As with any injury, the sooner it is discovered, it creates the best opportunity for optimal recovery. And, as with anything, the honesty of the veteran and family member and the pro-active and compassionate efforts of the care team create the most POSITIVE atmosphere for healing.
Please review the following websites that we have located on Traumatic Brain Injury. If you think that you, or someone that you care about has sustained TBI, please consider informing your care team immediately. Veterans have paid a heavy price for us all and we must do all we can together to make the “journey home” one that offers hope and support so bravely earned.
Brain Injury Association of America – http://www.biausa.org/. Information about brain injuries and living with them for the injured, families and caregivers.
- Center for Deployment Psychology – http://deploymentpsych.org/training/training-catalog/course-119-online-the-fundamentals-of-traumatic-brain-injury-tbi Free training about TBI. Click on “Take for Free” and receive a very up-to-date review of TBI and how it may be diagnosed and/or treated. (NOTE: if the link does not connect immediately, follow prompts and it should connect).
- Cognitive Systems – http://www.cog-systems.com/ innovative treatment for mild traumatic brain injury and other neurological injuries that can be done from home.
- Defense and Veterans Brain Injury Center – www.dvbic.org The mission of the Defense and Veterans Brain Injury Center (DVBIC) is to serve active duty military, their beneficiaries, and veterans with traumatic brain injuries (TBIs) through state-of-the-art clinical care, innovative clinical research initiatives and educational programs.
- Luminosity – www.luminosity.com This website is full of brain exercises. We investigated the site and were intrigued by the games developed to stimulate different neuro pathways. We suggest that visitors to the site be vigilant of any potential financial costs. Our first investigation said “first 3 games free” and we have not investigated further, so consider this as you explore.
- Resurrecting Lives – TBI – www.ResurrectingLives.org This organization is dedicated to systematically, efficiently and successfully diagnosing and treating veterans who are returning from war primarily in Iraq and Afghanistan for Traumatic Brain Injury (TBI) while also contributing to the prevention of TBI in the future. Helpful information is available on this site.
NEW! Traumatic Brain Injury (DCoE) developed Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health
Provides guidance on the assessment and management of patients with the co-occurring conditions of concussion, post-traumatic stress disorder, pain, depression and substance use disorder.