CoChat
Sign Up
Cited by 97

Traumatic Brain Injury Incidence, Clinical Overview, and Policies in the US Military Health System Since 2000

Swanson, Thomas M., Isaacson, Brad M., Cyborski, Cherina M., French, Louis M., Tsao, Jack W., Pasquina, Paul F.·2017·Public Health Reports®
DOI 10.1177/0033354916687748
Open this paper in CoChat — free account

Abstract

Exposure to explosive armaments during Operation Iraqi Freedom and Operation Enduring Freedom contributed to approximately 14% of the 352 612 traumatic brain injury (TBI) diagnoses in the US military between 2000 and 2016. The US Department of Defense issued guidelines in 2009 to (1) standardize TBI diagnostic criteria; (2) classify TBI according to mechanism and severity; (3) categorize TBI symptoms as somatic, psychological, or cognitive; and (4) systematize types of care given during the acute and rehabilitation stages of TBI treatment. Polytrauma and associated psychological and neurologic conditions may create barriers to optimal rehabilitation from TBI. Given the completion of recent combat operations and the transition of TBI patients into long-term care within the US Department of Veterans Affairs system, a review of the literature concerning TBI is timely. Long-term follow-up care for patients who have sustained TBI will remain a critical issue for the US military.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1177/0033354916687748

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 78

  1. [1]1. Management of Concussion/mTBI Working Group. VA/DoD Clinical Practice Guideline for Management of Concussion/Mild Traumatic Brain Injury. Washington, DC: US Department of Veterans Affairs, US Department of Defense; 2016. [Google Scholar]
  2. [2]2. Bagalman E. Traumatic Brain Injury Among Veterans. Washington, DC: Congressional Research Service; 2013. [Google Scholar]
  3. [3]3. Terrio H, Brenner LA, Ivins BJ, et al. Traumatic brain injury screening: preliminary findings in a US Army Brigade Combat Team. J Head Trauma Rehabil. 2009;24(1):14–23. [DOI] [PubMed] [Google Scholar]
  4. [4]4. Taber KH, Hurley RA. OEF/OIF deployment-related traumatic brain injury. PTSD Res Q. 2010;21(1):1–8. [Google Scholar]
  5. [6]6. Isaacson BM, Swanson TM, Potter BK, Pasquina PF. Tourniquet use in combat-injured service members: a link with heterotopic ossification? Orthopedic Res Rev. 2014;6:27–31. [Google Scholar]
  6. [7]7. Isaacson BM, Weeks SR, Pasquina PF, Webster JB, Beck JP, Bloebaum RD. The road to recovery and rehabilitation for injured service members with limb loss: a focus on Iraq and Afghanistan. US Army Med Dep J. Jul-Sep 2010:31–36. [PubMed] [Google Scholar]
  7. [9]9. Schmid KE, Tortella FC. The diagnosis of traumatic brain injury on the battlefield. Front Neurol. 2012;3:90. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. [10]10. Owens BD, Kragh JF, Jr, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom. J Trauma. 2008;64(2):295–299. [DOI] [PubMed] [Google Scholar]
  9. [11]11. Taielian T, Jaycox LH, eds. Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Santa Monica, CA: RAND Corp; 2008. [Google Scholar]
  10. [13]13. Cernak I, Noble-Haeusslein LJ. Traumatic brain injury: an overview of pathobiology with emphasis on military populations [published erratum appears in J Cereb Blood Flow Metab. 2010;30(6):1262]. J Cereb Blood Flow Metab. 2010;30(2):255–266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. [14]14. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;2(7872):81–84. [DOI] [PubMed] [Google Scholar]
  12. [15]15. Parikh S, Koch M, Narayan RK. Traumatic brain injury. Int Anesthesiol Clin. 2007;45(3):119–135. [DOI] [PubMed] [Google Scholar]
  13. [16]16. Green SM. Cheerio, laddie! Bidding farewell to the Glasgow Coma Scale. Ann Emerg Med. 2011;58(5):427–430. [DOI] [PubMed] [Google Scholar]
  14. [17]17. Ponsford J, Draper K, Schönberger M. Functional outcome 10 years after traumatic brain injury: its relationship with demographic, injury severity, and cognitive and emotional status. J Int Neuropsychol Soc. 2008;14(2):233–242. [DOI] [PubMed] [Google Scholar]
  15. [18]18. Busch RM, McBride A, Curtiss G, Vanderploeg RD. The components of executive functioning in traumatic brain injury. J Clin Exp Neuropsychol. 2005;27(8):1022–1032. [DOI] [PubMed] [Google Scholar]
  16. [19]19. Kim E. Agitation, aggression, and disinhibition syndromes after traumatic brain injury. NeuroRehabilitation. 2002;17(4):297–310. [PubMed] [Google Scholar]
  17. [20]20. Williams C, Wood RL. Alexithymia and emotional empathy following traumatic brain injury. J Clin Exp Neuropsychol. 2010;32(3):259–267. [DOI] [PubMed] [Google Scholar]
  18. [21]21. Dinkel J, Drier A, Khalilzadeh O, et al. Long-term white matter changes after severe traumatic brain injury: a 5-year prospective cohort. AJNR Am J Neuroradiol. 2014;35(1):23–29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. [22]22. Yang FPG, Shetty C, Lee H, et al. A longitudinal study of microstructural white matter changes after mild traumatic brain injury. Proc Int Soc Mag Reson Med. 2011;19:346. [Google Scholar]
  20. [23]23. Shenton ME, Hamoda HM, Schneiderman JS, et al. A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging Behav. 2012;6(2):137–192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. [24]24. Palacios EM, Sala-Llonch R, Junque C, et al. Long-term declarative memory deficits in diffuse TBI: correlations with cortical thickness, white matter integrity and hippocampal volume. Cortex. 2013;49(3):646–657. [DOI] [PubMed] [Google Scholar]
  22. [26]26. Hulkower MB, Poliak DB, Rosenbaum SB, Zimmerman ME, Lipton ML. A decade of DTI in traumatic brain injury: 10 years and 100 articles later. AJNR Am J Neuroradiol. 2013;34(11):2064–2074. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. [27]27. Wortzel HS, Kraus MF, Filley CM, Anderson CA, Arciniegas DB. Diffusion tensor imaging in mild traumatic brain injury litigation. J Am Acad Psychiatry Law. 2011;39(4):511–523. [PubMed] [Google Scholar]
  24. [28]28. Dams-O’Connor K, Gibbons LE, Bowen JD, McCurry SM, Larson EB, Crane PK. Risk for late-life re-injury, dementia and death among individuals with traumatic brain injury: a population-based study. J Neurol Neurosurg Psychiatry. 2013;84(2):177–182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. [29]29. MacKenzie JD, Siddiqi F, Babb JS, et al. Brain atrophy in mild or moderate traumatic brain injury: a longitudinal quantitative analysis. AJNR Am J Neuroradiol. 2002;23(9):1509–1515. [PMC free article] [PubMed] [Google Scholar]
  26. [30]30. Blyth BJ, Bazarian JJ. Traumatic alterations in consciousness: traumatic brain injury. Emerg Med Clin North Am. 2010;28(3):571–594. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. [31]31. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–463. [DOI] [PubMed] [Google Scholar]
  28. [32]32. Lee LK. Controversies in the sequelae of pediatric mild traumatic brain injury. Pediatr Emerg Care. 2007;23(8):580–583. [DOI] [PubMed] [Google Scholar]
  29. [33]33. Boyle E, Cancelliere C, Hartvigsen J, Carrol LJ, Holm LW, Cassidy D. Systematic review of prognosis after mild traumatic brain injury in the military: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95(3):S230–S237. [DOI] [PubMed] [Google Scholar]
  30. [34]34. Brazinova A, Mauritz W, Leitgeb J, et al. Outcomes of patients with severe traumatic brain injury who have Glasgow Coma Scale scores of 3 or 4 and are over 65 years old. J Neurotrauma. 2010;27(9):1549–1555. [DOI] [PubMed] [Google Scholar]
  31. [35]35. Cooper DB, Kennedy JE, Cullen MA, Critchfield E, Amador RR, Bowles AO. Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries. Brain Inj. 2011;25(1):1–7. [DOI] [PubMed] [Google Scholar]
  32. [36]36. Cooper DB, Mercado-Couch JM, Critchfield E, et al. Factors influencing cognitive functioning following mild traumatic brain injury in OIF/OEF burn patients. NeuroRehabilitation. 2010;26(3):233–238. [DOI] [PubMed] [Google Scholar]
  33. [37]37. Kennedy JE, Cullen MA, Amador RR, Huey JC, Leal FO. Symptoms in military service members after blast mTBI with and without associated injuries. NeuroRehabilitation. 2010;26(3):191–197. [DOI] [PubMed] [Google Scholar]
  34. [38]38. Greenwald BD, Burnett DM, Miller MA. Congenital and acquired brain injury: 1. Brain injury: epidemiology and pathophysiology. Arch Phys Med Rehabil. 2003;84(3, suppl 1):S3–S7. [PubMed] [Google Scholar]
  35. [39]39. Zink BJ. Traumatic brain injury outcome: concepts for emergency care. Ann Emerg Med. 2001;37(3):318–332. [DOI] [PubMed] [Google Scholar]
  36. [40]40. Yuh EL, Dillon WP. Intracranial hypotension and intracranial hypertension. Neuroimaging Clin N Am. 2010;20(4):597–617. [DOI] [PubMed] [Google Scholar]
  37. [41]41. Ghajar J. Traumatic brain injury. Lancet. 2000;356(9233):923–929. [DOI] [PubMed] [Google Scholar]
  38. [42]42. Gruen P. Surgical management of head trauma. Neuroimaging Clin N Am. 2002;12(2):339–343. [DOI] [PubMed] [Google Scholar]
  39. [43]43. Dunn IF, Ellegala DB. Decompressive hemicraniectomy in the management of severe traumatic brain injury In: Bhardwaj Ellegala DB, Kirsch JR, eds. Acute Brain and Spinal Cord Injury: Evolving Paradigms and Management. New York: Informa Health Care USA Inc; 2008:1–16. [Google Scholar]
  40. [44]44. Cruz J, Minoja G, Okuchi K, Facco E. Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg. 2004;100(3):376–383. [DOI] [PubMed] [Google Scholar]
  41. [45]45. Curry R, Hollingworth W, Ellenbogen RG, Vavilala MS. Incidence of hypo- and hypercarbia in severe traumatic brain injury before and after 2003 pediatric guidelines. Pediatr Crit Care Med. 2008;9(2):141–146. [DOI] [PubMed] [Google Scholar]
  42. [46]46. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728–741. [DOI] [PubMed] [Google Scholar]
  43. [47]47. Marshall LF. Head injury: recent past, present, and future. Neurosurgery. 2000;47(3):546–561. [DOI] [PubMed] [Google Scholar]
  44. [48]48. Risdall JE, Menon DK. Traumatic brain injury. Philos Trans R Soc Lond B Biol Sci. 2011;366(1562):241–250. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. [49]49. Ling G, Bandak F, Armonda R, Grant G, Ecklund J. Explosive blast neurotrauma. J Neurotrauma. 2009;26(6):815–825. [DOI] [PubMed] [Google Scholar]
  46. [50]50. Silverberg ND, Iverson GL. Is rest after concussion “the best medicine?” Recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil. 2013;28(4):250–258. [DOI] [PubMed] [Google Scholar]
  47. [51]51. Mott TF, McConnon ML, Rieger BP. Subacute to chronic mild traumatic brain injury. Am Fam Physician. 2012;86(11):1045–1051. [PubMed] [Google Scholar]
  48. [52]52. Spira JL, Lathan CE, Bleiberg J, Tsao JW. The impact of multiple concussions on emotional distress, post-concussive symptoms, and neurocognitive functioning in active duty United States Marines independent of combat exposure or emotional distress. J Neurotrauma. 2014;31(22):1823–1834. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. [53]53. Turner-Stokes L, Disler PB, Nair A, Wade DT. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database Syst Rev. 2005;(3):CD004170. [DOI] [PubMed] [Google Scholar]
  50. [54]54. Thornton KE, Carmody DP. Efficacy of traumatic brain injury rehabilitation: interventions of QEEG-guided biofeedback, computers, strategies, and medications. Appl Psychophysiol Biofeedback. 2008;33(2):101–124. [DOI] [PubMed] [Google Scholar]
  51. [55]55. Agrawal A, Timothy J, Pandit L, Manju M. Post-traumatic epilepsy: an overview. Clin Neurol Neurosurg. 2006;108(5):433–439. [DOI] [PubMed] [Google Scholar]
  52. [56]56. Comper P, Bisschop SM, Carnide N, Tricco A. A systematic review of treatments for mild traumatic brain injury. Brain Inj. 2005;19(11):863–880. [DOI] [PubMed] [Google Scholar]
  53. [57]57. Silver JM, McAllister TW, Arciniegas DB. Depression and cognitive complaints following mild traumatic brain injury. Am J Psychiatry. 2009;166(6):653–661. [DOI] [PubMed] [Google Scholar]
  54. [58]58. Deb S, Crownshaw T. The role of pharmacotherapy in the management of behaviour disorders in traumatic brain injury patients. Brain Inj. 2004;18(1):1–31. [DOI] [PubMed] [Google Scholar]
  55. [59]59. Rosenthal M, Christensen BK, Ross TP. Depression following traumatic brain injury. Arch Phys Med Rehabil. 1998;79(1):90–103. [DOI] [PubMed] [Google Scholar]
  56. [60]60. Malec JF. Impact of comprehensive day treatment on societal participation for persons with acquired brain injury. Arch Phys Med Rehabil. 2001;82(7):885–895. [DOI] [PubMed] [Google Scholar]
  57. [61]61. Cicerone KD, Mott T, Azulay J, Friel JC. Community integration and satisfaction with functioning after intensive cognitive rehabilitation for traumatic brain injury. Arch Phys Med Rehabil. 2004;85(6):943–950. [DOI] [PubMed] [Google Scholar]
  58. [62]62. Borg J, Holm L, Cassidy JD, et al. Diagnostic procedures in mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004;43(suppl):61–75. [DOI] [PubMed] [Google Scholar]
  59. [63]63. Iverson GL. Outcome from mild traumatic brain injury. Curr Opin Psychiatry. 2005;18(3):301–317. [DOI] [PubMed] [Google Scholar]
  60. [64]64. Alexander MP. Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology. 1995;45(7):1253–1260. [DOI] [PubMed] [Google Scholar]
  61. [65]65. Curran CA, Ponsford JL, Crowe S. Coping strategies and emotional outcome following traumatic brain injury: a comparison with orthopedic patients. J Head Trauma Rehabil. 2000;15(6):1256–1274. [DOI] [PubMed] [Google Scholar]
  62. [66]66. Moser RS, Iverson GL, Echemendia RJ, et al. Neuropsychological evaluation in the diagnosis and management of sports-related concussion. Arch Clin Neuropsychol. 2007;22(8):909–916. [DOI] [PubMed] [Google Scholar]
  63. [67]67. Macciocchi SN, Barth JT, Alves W, Rimel RW, Jane JA. Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery. 1996;39(3):510–514. [PubMed] [Google Scholar]
  64. [68]68. McCrea M, Iverson GL, McAllister TW, et al. An integrated review of recovery after mild traumatic brain injury (MTBI): implications for clinical management. Clin Neuropsychol. 2009;23(8):1368–1390. [DOI] [PubMed] [Google Scholar]
  65. [69]69. Dean PJ, Sterr A. Long-term effects of mild traumatic brain injury on cognitive performance. Front Hum Neurosci. 2013;7:30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. [70]70. Konrad C, Geburek AJ, Rist F, et al. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med. 2011;41(6):1197–1211. [DOI] [PubMed] [Google Scholar]
  67. [71]71. Lew HL, Poole JH, Guillory SB, Salerno RM, Leskin G, Sigford B. Persistent problems after traumatic brain injury: the need for long-term follow-up and coordinated care. J Rehabil Res Dev. 2006;43(2):vii–x. [DOI] [PubMed] [Google Scholar]
  68. [72]72. Zumstein MA, Moser M, Mottini M, et al. Long-term outcome in patients with mild traumatic brain injury: a prospective observational study. J Trauma. 2011;71(1):120–127. [DOI] [PubMed] [Google Scholar]
  69. [73]73. Vanderploeg RD, Curtiss G, Belanger HG. Long-term neuropsychological outcomes following mild traumatic brain injury. J Int Neuropsychol Soc. 2005;11(3):228–236. [DOI] [PubMed] [Google Scholar]
  70. [74]74. Vanderploeg RD, Curtiss G, Luis CA, Salazar AM. Long-term morbidities following self-reported mild traumatic brain injury. J Clin Exp Neuropsychol. 2007;29(6):585–598. [DOI] [PubMed] [Google Scholar]
  71. [75]75. Fischer H. A Guide to US Military Casualty Statistics: Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom. Washington, DC: Congressional Research Service; 2014. [Google Scholar]
  72. [76]76. French LM, Lange RT, Brickell TA. Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury. J Rehabil Res Dev. 2014;51(6):933–950. [DOI] [PubMed] [Google Scholar]
  73. [78]78. Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM. Posttraumatic stress disorder mediates the relationship between mild traumatic brain injury and health and psychosocial functioning in veterans of Operations Enduring Freedom and Iraqi Freedom. J Nerv Ment Dis. 2009;197(10):748–753. [DOI] [PubMed] [Google Scholar]
  74. [79]79. Cifu DX, Blake C. Overcoming Post-deployment Syndrome. New York, NY: Demos Medical Publishing; 2011. [Google Scholar]
  75. [80]80. Masel BE, DeWitt DS. Traumatic brain injury: a disease process, not an event. J Neurotrauma. 2010;27(8):1529–1549. [DOI] [PubMed] [Google Scholar]
  76. [81]81. Harrison-Felix CL, Whiteneck GG, Jha A, DeVivo MJ, Hammond FM, Hart DM. Mortality over four decades after traumatic brain injury rehabilitation: a retrospective cohort study. Arch Phys Med Rehabil. 2009;90(9):1506–1513. [DOI] [PubMed] [Google Scholar]
  77. [82]82. Harrison-Felix C, Whiteneck G, DeVivo MJ, Hammond FM, Jha A. Causes of death following 1 year postinjury among individuals with traumatic brain injury. J Head Trauma Rehabil. 2006;21(1):22–33. [DOI] [PubMed] [Google Scholar]
  78. [84]84. Aimaretti G, Ambrosio MR, Di Somma C, et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J Clin Endocrinol Metab. 2005;90(11):6085–6092. [DOI] [PubMed] [Google Scholar]

Cited by

Sorted by citations

Authors
Swanson, T. M., Isaacson, B. M., Cyborski, C. M., French, L. M., Tsao, J. W., & Pasquina, P. F.
Affiliations
Department of Physical Medicine and Rehabilitation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Venue
Public Health Reports®
Publisher
SAGE Publications
Published
2017-01-30
Volume
132
Issue
2
Pages
251-259
ISSN
  • 0033-3549
  • 1468-2877
DOI
10.1177/0033354916687748
Cited by
97
References
4
Language
en
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review