12 October 2009

Progress with treatment of traumatic brain injuries

Here's some encouraging news. Due to early screening as well as an ever-developing program of psychological and medical treatments, more soldiers are successfully recovering from TBI.

Maj. Alan Hopewell, officer in charge of the Traumatic Brain Injury Clinic at the Carl R. Darnall Army Medical Hospital [at Fort Hood], said the Defense and Veterans Brain Injury Center is reporting that Army-wide 90 percent of soldiers are returning to duty after treatment and therapy.

"We don't have the breakdown yet, but the large majority are getting well and able to return to duty," Hopewell said. "I think the public and the media thinks everyone that's injured is having problems. But the good news is they are doing well. It's only a small number that we have to do more aggressive treatment."

The Traumatic Brain Injury Clinic at Fort Hood sees close to 10,000 patients a year.

The treatment is a combination of psychological and medical treatments.

"This is a medical injury, not a psychological injury," Hopewell said. "It's a medical injury that affects the nervous system in the body. People can have psychological reactions to it. For example they may hurt or not be able to work."

Medications are used to help stabilize the brain and how it works. In a rare form TBI can develop electrical abnormalities in the brain, Hopewell said. There are medications that will calm the nervous system. Other medications treat nausea, balance, and vision problems.

"We are looking at secondary effects in ears and eyes that may take consultation by an eye doctor or ear nose and throat specialist."

Other treatments involve speech and occupational therapists. Their treatments improve speech communication and thinking and reasoning ability, Hopewell said. These are things disrupted by concussion or head injury.

Viewed as a flow chart, a Fort Hood soldier injured in combat goes first to an aid station, then to a Level II medical clinic or the combat support hospital. After that it's evacuation time to Balad, Iraq and Landstuhl, Germany. These are staging points for a lot of brain injuries.

Afterward it's to Fort Hood if the patient is doing well. If they are having problems they go to Walter Reed Army Medical Center in Washington or Brooke Army Medical Center in San Antonio.

"Screening for TBI is not just done at Fort Hood," Hopewell said. "It's done at every step along the way."

"When I see a soldier in my clinic I am able to go back and look at results of all the exams and the doctors who have seen them," Hopewell said.

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