Brain injury a 'signature' of Iraq war

By DICK FOSTER
Wednesday, April 11, 2007

Army Capt. Matthew Staton went to Iraq in 2003 with the first wave of Fort Carson soldiers.

Months after his return in 2004 he realized he was seriously wounded.

"My wife could give me a (spoken) grocery list. The grocery store was three minutes from my house. I could leave the house, go to the grocery store and would completely have forgotten what I went there for," he said.

Staton has a traumatic brain injury, or TBI. It was caused by the concussive blasts of roadside bombs, known in Army parlance as IEDs, or improvised explosive devices.

"TBI may well be the signature injury of this war," said Col. John Cho, commander of Fort Carson's Evans Army Medical Center.

Nearly one in six Fort Carson Iraq veterans have been diagnosed with traumatic brain injuries, according to a two-year study released Tuesday by Fort Carson's medical staff.

"I was wounded from small arms fire. I had a gunshot wound in the upper thigh. But I was exposed to multiple IED blasts," said Staton.

IEDs are the deadliest weapon of Iraq's insurgents. They have been used against coalition troops throughout the four-year war.

The bombs often destroy military vehicles and kill those inside, but the explosive concussion also can cause brain injuries to those nearby, jarring the brain around inside the skull.

Staton said he'd been near 50 or more IED explosions in Iraq.

"It's like getting your bell rung," he said of the blasts. "It's overwhelming. Sometimes you see stars. Sometimes it's a big dust cloud. Sometimes you're far enough away it's just a loud boom."

Soldiers close to IEDs when they detonate can be knocked unconscious or suffer severe injuries, Staton said.

Fort Carson has examined 13,440 Iraq veterans since it began its study in June 2005. It found TBI in 17.8 percent of them, ranging from mild to severe cases.

The majority of TBI victims are able to recover with proper therapy, rest and rehabilitation, which include mental exercises such as playing cards and other games that stimulate brain activity.

But about one in eight of the soldiers diagnosed with TBI are so severely injured that they must be discharged from the Army, said Col. Heidi Terrio, Fort Carson's chief of deployment health.

Staton, the father of a young daughter, is facing medical discharge for severe TBI.

"It's frustrating, it's depressing, it's aggravating, it's disheartening,'' he said. "I mean, I'm a 30-year-old man. I have to find devices to live with it and figure out how to work through and to overcome."

Although the Army recognized blast injuries soon after the Iraq war began, it is still conducting studies on the physical effects and how best to deal with them.

"We still do not understand the basic pathophysiology behind TBI," said Cho. "We do not understand it at a molecular level."

Cho said the injury is unlike concussions seen in athletics and civilian accidents.

The symptoms _ headaches, memory problems, irritability, sleep irregularity, dizziness and balance problems _ may take weeks or months to exhibit themselves.

Some soldiers have not shown symptoms until they have returned home from Iraq.

The Army is "recognizing that the treatment of mild TBI can't wait until the soldier returns," Cho said. "The inception of therapy and treatment has to occur downrange (in theater)."

TRAUMATIC BRAIN INJURY

_ What it is: A blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. For U.S. troops in Iraq, the injury is often related to the concussive blasts of roadside bombs called improvised explosive devices (IEDs). The exact physiological action that causes the brain injury is still unknown. Impairment can range from mild and temporary to severe and long lasting.

_ Symptoms: Headaches, dizziness, irritability, sleep problems, and problems with concentration, memory, vision and hearing.

_ Treatment: Get lots of sleep, don't overexert, return gradually to normal activities; avoid activities that could lead to further injury, such as contact sports; refrain from alcohol as it may slow recovery; keep brain engaged with mental activities such as cards, drawing, writing or playing a musical instrument, avoid irritable situations.

_ Help Available: Brain Injury Association of America, 1-800-444-6443, or www.biausa.org Army Wounded Warrior Program, 1-800-237-1336, or www.aw2. army.mil

Source: Fort Carson Soldier Readiness Center