What is Blast-Related Mild Traumatic Brain Injury?

Blast exposure is often reported by military personnel who have been deployed to recent wars in Iraq and Afghanistan. Difficulties of returning personnel with reintegrating into civilian society have in part been attributed to brain injury that was caused by blast concussions.

Although much of the blast-related TBI research in military populations is focused on injuries incurred during combat, Service members are also at risk of exposure to multiple low-level blasts during operational and training activities, such as breacher training. Exposure to repetitive low-level blasts could result in subconcussive injury and subsequent cumulative neurological effects. For more information on the effects of repetitive low-level blast exposure on military operations in garrison, see the meeting proceedings from the Seventh DoD International State-of-the-Science Meeting: The Neurological Effects of Repeated Exposure to Military Occupational Blast: Implications for Prevention and Health.52

Comorbidities

In many cases, particularly in military populations, TBI is accompanied by substance abuse and psychiatric comorbidities.96 The substantial overlap in symptomology between TBI and psychological disorders, namely, PTSD, can make it difficult to parse out symptom cause and their role in long-term outcomes (Figure 3). Several studies have shown that TBI with comorbid conditions is associated with a greater likelihood of experiencing PCS, suggesting that TBI alone may not account for the symptoms or severity of outcome.98,99 There is a growing body of evidence that some of the outcomes attributed to TBI are actually a result of the comorbidities alone. To delve into the relationship of TBI and comorbidities with outcome, consider these well-written reviews.36,100

According to the Defense and Veterans Brain Injury Center, Traumatic brain injury (TBI) is a significant health issue which affects service members and veterans during times of both peace and war. Active duty and reserve service members are at increased risk for sustaining a TBI compared to their civilian peers.

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