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Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care.
Mt Sinai J Med. 2009 Apr; 76(2):111-8.MS

Abstract

Mild traumatic brain injury has been called the signature injury of the wars in Iraq and Afghanistan. In both theaters of operation, traumatic brain injury has been a significant cause of mortality and morbidity, with blast-related injury the most common cause. Improvised explosive devices have been the major cause of blast injuries. It is estimated that 10% to 20% of veterans returning from these operations have suffered a traumatic brain injury, and there is concern that blast-related injury may produce adverse long-term health affects and affect the resilience and in-theater performance of troops. Blast-related injury occurs through several mechanisms related to the nature of the blast overpressure wave itself as well as secondary and tertiary injuries. Animal studies clearly show that blast overpressure waves are transmitted to the brain and can cause changes that neuropathologically are most similar to diffuse axonal injury. One striking feature of the mild traumatic brain injury cases being seen in veterans of the wars in Iraq and Afghanistan is the high association of mild traumatic brain injury with posttraumatic stress disorder. The overlap in symptoms between the disorders has made distinguishing them clinically challenging. The high rates of mild traumatic brain injury and posttraumatic stress disorder in the current operations are of significant concern for the long-term health of US veterans with associated economic implications.

Authors+Show Affiliations

James J Peters Department of Veterans Affairs Medical Center, Rehabilitation Medicine Service, Bronx, NY, USA. gregory.elder@va.govNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19306373

Citation

Elder, Gregory A., and Adrian Cristian. "Blast-related Mild Traumatic Brain Injury: Mechanisms of Injury and Impact On Clinical Care." The Mount Sinai Journal of Medicine, New York, vol. 76, no. 2, 2009, pp. 111-8.
Elder GA, Cristian A. Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care. Mt Sinai J Med. 2009;76(2):111-8.
Elder, G. A., & Cristian, A. (2009). Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care. The Mount Sinai Journal of Medicine, New York, 76(2), 111-8. https://doi.org/10.1002/msj.20098
Elder GA, Cristian A. Blast-related Mild Traumatic Brain Injury: Mechanisms of Injury and Impact On Clinical Care. Mt Sinai J Med. 2009;76(2):111-8. PubMed PMID: 19306373.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care. AU - Elder,Gregory A, AU - Cristian,Adrian, PY - 2009/3/24/entrez PY - 2009/3/24/pubmed PY - 2009/6/12/medline SP - 111 EP - 8 JF - The Mount Sinai journal of medicine, New York JO - Mt Sinai J Med VL - 76 IS - 2 N2 - Mild traumatic brain injury has been called the signature injury of the wars in Iraq and Afghanistan. In both theaters of operation, traumatic brain injury has been a significant cause of mortality and morbidity, with blast-related injury the most common cause. Improvised explosive devices have been the major cause of blast injuries. It is estimated that 10% to 20% of veterans returning from these operations have suffered a traumatic brain injury, and there is concern that blast-related injury may produce adverse long-term health affects and affect the resilience and in-theater performance of troops. Blast-related injury occurs through several mechanisms related to the nature of the blast overpressure wave itself as well as secondary and tertiary injuries. Animal studies clearly show that blast overpressure waves are transmitted to the brain and can cause changes that neuropathologically are most similar to diffuse axonal injury. One striking feature of the mild traumatic brain injury cases being seen in veterans of the wars in Iraq and Afghanistan is the high association of mild traumatic brain injury with posttraumatic stress disorder. The overlap in symptoms between the disorders has made distinguishing them clinically challenging. The high rates of mild traumatic brain injury and posttraumatic stress disorder in the current operations are of significant concern for the long-term health of US veterans with associated economic implications. SN - 1931-7581 UR - https://www.unboundmedicine.com/medline/citation/19306373/Blast_related_mild_traumatic_brain_injury:_mechanisms_of_injury_and_impact_on_clinical_care_ L2 - https://doi.org/10.1002/msj.20098 DB - PRIME DP - Unbound Medicine ER -