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Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms.
J Head Trauma Rehabil. 2010 Jan-Feb; 25(1):9-14.JH

Abstract

OBJECTIVE

To determine whether screening for a blast mechanism of concussion identifies individuals at higher risk of persistent postconcussive symptoms (PCS).

SETTING

United States Army post.

PARTICIPANTS

3952 US Army infantry soldiers were administered anonymous surveys 3 to 6 months after returning from a yearlong deployment to Iraq.

MAIN OUTCOME MEASURES

Self-reported concussion (defined as an injury that resulted in being "dazed, confused, or 'seeing stars'"; "not remembering the injury"; or "losing consciousness [knocked out]): Patient Health Questionnaire 15-item scale for physical symptoms and PCS; Posttraumatic Stress Disorder Checklist; and Patient Health Questionnaire depression module.

RESULTS

Of the 587 soldiers (14.9% of the total sample) who met criteria for concussion, 201 (34.2%) reported loss of consciousness, and 373 (63.5%) reported only an alteration of consciousness without loss of consciousness; 424 (72.2%) reported a blast mechanism, and 150 (25.6%) reported a nonblast mechanism. Among soldiers who lost consciousness, blast mechanism was significantly associated with headaches and tinnitus 3 to 6 months postdeployment compared with a nonblast mechanism. However, among the larger group of soldiers reporting concussions without loss of consciousness, blast was not associated with adverse health outcomes.

CONCLUSIONS

Blast mechanism of concussion was inconsistently associated with PCS, depending on the definition of concussion utilized. A self-reported history of blast mechanism was not associated with persistent PCS for the majority of US soldiers with concussions.

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Authors+Show Affiliations

Wilk JE
Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, US Army Medical Research and Materiel Command, Silver Spring, Maryland 20910, USA. joshua.wilk@amedd.army.mil
Thomas JL
No affiliation info available
McGurk DM
No affiliation info available
Riviere LA
No affiliation info available
Castro CA
No affiliation info available
Hoge CW
No affiliation info available

MeSH

Blast InjuriesBrain ConcussionCombat DisordersConsciousness DisordersCross-Sectional StudiesDepressive Disorder, MajorFollow-Up StudiesHealth SurveysHumansIncidenceIraq War, 2003-2011MaleMass ScreeningMilitary PersonnelNeurologic ExaminationPost-Concussion SyndromeRisk FactorsStatistics as TopicSurveys and QuestionnairesUnconsciousness

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20051900

Citation

Wilk, Joshua E., et al. "Mild Traumatic Brain Injury (concussion) During Combat: Lack of Association of Blast Mechanism With Persistent Postconcussive Symptoms." The Journal of Head Trauma Rehabilitation, vol. 25, no. 1, 2010, pp. 9-14.
Wilk JE, Thomas JL, McGurk DM, et al. Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms. J Head Trauma Rehabil. 2010;25(1):9-14.
Wilk, J. E., Thomas, J. L., McGurk, D. M., Riviere, L. A., Castro, C. A., & Hoge, C. W. (2010). Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms. The Journal of Head Trauma Rehabilitation, 25(1), 9-14. https://doi.org/10.1097/HTR.0b013e3181bd090f
Wilk JE, et al. Mild Traumatic Brain Injury (concussion) During Combat: Lack of Association of Blast Mechanism With Persistent Postconcussive Symptoms. J Head Trauma Rehabil. 2010 Jan-Feb;25(1):9-14. PubMed PMID: 20051900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mild traumatic brain injury (concussion) during combat: lack of association of blast mechanism with persistent postconcussive symptoms. AU - Wilk,Joshua E, AU - Thomas,Jeffrey L, AU - McGurk,Dennis M, AU - Riviere,Lyndon A, AU - Castro,Carl A, AU - Hoge,Charles W, PY - 2010/1/7/entrez PY - 2010/1/7/pubmed PY - 2010/3/30/medline SP - 9 EP - 14 JF - The Journal of head trauma rehabilitation JO - J Head Trauma Rehabil VL - 25 IS - 1 N2 - OBJECTIVE: To determine whether screening for a blast mechanism of concussion identifies individuals at higher risk of persistent postconcussive symptoms (PCS). SETTING: United States Army post. PARTICIPANTS: 3952 US Army infantry soldiers were administered anonymous surveys 3 to 6 months after returning from a yearlong deployment to Iraq. MAIN OUTCOME MEASURES: Self-reported concussion (defined as an injury that resulted in being "dazed, confused, or 'seeing stars'"; "not remembering the injury"; or "losing consciousness [knocked out]): Patient Health Questionnaire 15-item scale for physical symptoms and PCS; Posttraumatic Stress Disorder Checklist; and Patient Health Questionnaire depression module. RESULTS: Of the 587 soldiers (14.9% of the total sample) who met criteria for concussion, 201 (34.2%) reported loss of consciousness, and 373 (63.5%) reported only an alteration of consciousness without loss of consciousness; 424 (72.2%) reported a blast mechanism, and 150 (25.6%) reported a nonblast mechanism. Among soldiers who lost consciousness, blast mechanism was significantly associated with headaches and tinnitus 3 to 6 months postdeployment compared with a nonblast mechanism. However, among the larger group of soldiers reporting concussions without loss of consciousness, blast was not associated with adverse health outcomes. CONCLUSIONS: Blast mechanism of concussion was inconsistently associated with PCS, depending on the definition of concussion utilized. A self-reported history of blast mechanism was not associated with persistent PCS for the majority of US soldiers with concussions. SN - 1550-509X UR - https://www.unboundmedicine.com/medline/citation/20051900/Mild_traumatic_brain_injury__concussion__during_combat:_lack_of_association_of_blast_mechanism_with_persistent_postconcussive_symptoms_ L2 - https://doi.org/10.1097/HTR.0b013e3181bd090f DB - PRIME DP - Unbound Medicine ER -