Researchers at the Washington University School of Medicine in St. Louis investigated blast-related traumatic brain injuries to U.S military service members who served in Afghanistan and Iraq. For the study, researchers examined 255 U.S. military personnel who were injured during active duty. About 20 percent of those examined had experienced some type of head injury during their deployment, and of those soldiers with head injuries, 83 percent have been diagnosed with a mild form of traumatic brain injury (TBI).
The study also focused on 178 patients over the course of six to twelve months in order to evaluate the long-term outcomes of their TBI. Results showed that 53 patients had developed a mild TBI that was blast-related, and 29 patients had developed a mild TBI that was not caused by an explosion. According to David L. Brody, MD, PhD, associate professor of neurology, “It’s also possible these brain injuries in military personnel that resulted in medical evacuation were more severe than we typically see in a civilian population. After a sports-related concussion, for example, many people make a good recovery over several weeks.”
These new studies show that military personnel with blast-related mild brain trauma had similar outcomes to those with mild brain injury from other causes.
Traumatic brain injury accounts for approximately 10 percent of patients attending the accident and emergency department, and occurs in about 200-450 people for every 100,000 people.
Head injuries can result in a number of consequences beyond the initial cause of the accident. Results show that patients with TBI in both blast-related and non-blast-related instances, suffer equally from disabilities, post-traumatic stress disorder (PTSD), seizures, headaches, depression, and pituitary dysfunction as a result. Pituitary dysfunction is a rare but serious result of TBI, where there is either too little or too much of one hormone in the pituitary gland in the brain. This hormone imbalance affects the function of other glands in the body, thereby causing neuroendocrine problems. There is evidence that long-term neuroendocrine dysfunction from TBI can interfere with a patient’s recovery and result in permanent brain damage.
According to the Virginia Commonwealth University Medical Center, military personnel with blast-related brain trauma may have pituitary dysfunction. A recent study by Dr. Taylor and his research team evaluated 37 male veterans who had been exposed to a blast of some type during their tour of duty. Of those veterans, 23 were diagnosed with mild blast-related TBI and 2 with moderate blast-related TBI. Their recovery stages varied from 2 months to almost 10 years. They found that many of the patients had a growth hormone deficiency and hypogonadism associated with low testosterone. The results from the laboratory tests would give doctors the means for diagnosing pituitary dysfunction, therefore allowing them to treat patients right away through hormone replacement and improve their symptoms. However, certain medications can interfere with laboratory testing, and depression as well as PTSD can affect diagnosing pituitary dysfunction. Dr. Taylor states that “Further study is needed to clarify the extent to which these conditions affect diagnosing true pituitary dysfunction among blast-related TBI survivors and to determine if hormone replacement will benefit them."
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