Department of Defense Reports on Brain Injuries in Troops

The Department of Defense (DoD) at the request of the Institute of Medicine recently issued a report on the efficacy of treating brain injured troops, but its conclusions are not firm because they lack strenuous scientific support, the report said.

Traumatic brain injury (TBI) is among the most common injuries sustained by troops fighting in Iraq and Afghanistan. About 20 percent of armed service members who are wounded in Iraq and Afghanistan have had forceful injuries to the face, neck or head. The number of brain injuries in the last ten years has gone from 11,000 to over 30,000

Dr. Ira Shoulson, professor of neurology at Georgetown University Medical Center and chairman of the panel that prepared the report told the New York Times on Oct. 11, 2011, that the evidence for the report’s conclusions was not firm enough because:

  • Causes and severity of the injuries vary greatly
  • Treatment techniques are usually individualized
  • Veterans have a number of related problems such as chronic pain, depression, and post-traumatic distress syndrome
  • Caregivers (including family members) and their methods varied widely

DoD spokeswoman Cynthia O. Smith told the Times that more than 71,000 hours of cognitive rehabilitation have been provided by the Pentagon, and the insurer Tricare has paid for about 54,000 hours of such care in private clinics for active duty, National Guard, and retired members of the service.

Family members of the injured have closely questioned the rehabilitation methods used to treat TBI. These include nonpenetrating blasts, blows to the head and wounds from bombs and bullets.

Dr. Nicholas Schiff, a neuroscientist at Weill Cornell Medical College in New York, told the Times, “because there’s no infrastructure, no organized plan of attack for what happens after a brain injury at all stages, you’re simply not going to find many large, well-designed studies that compare treatment options and outcomes.”

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