Better tests find record concussions among U.S. troops

By Gregg Zoroya, USA TODAY

Improved battlefield diagnosis has led to a record number of concussions detected among U.S. troops fighting in Afghanistan and Iraq last year, with an average of 16 inflicted each day last spring, according to newly released Pentagon figures.


U.S. Navy Capt. Michael Wagner, a neurologist stationed in Kandahar, leads a soldier through an exam after the solider was exposed to an IED blast. In the early years of the Iraq and Afghanistan wars, troops were rarely pulled aside and examined for signs of a concussion after being exposed to a roadside blast.

It was the highest pace for traumatic brain injuries of any period in 10 years of combat, according to data provided to USA TODAY. Brain injuries caused by the concussive force of a nearby blast are among the most commons wounds troops suffer.

American casualties in Afghanistan this spring are already ticking higher as the traditionally heavier summer fighting months approach, military statistics show.

Although there was an alarming increase last year in buried-explosives attacks on U.S. foot patrols in Afghanistan — where most of the casualties occurred last year — scientists believe the rise in diagnosed brain-injury cases was due largely to more aggressive efforts at detecting the wound.

“I do think that does account for the increase,” says Army Col. Jamie Grimes, national director of the Defense and Veterans Brain Injury Center, which conducts brain injury research.

As a consequence, experts fear that there were countless brain injuries missed when there were far more casualties during 2005 through 2007. Combat deaths then were twice the annual rate last year.

“You’re probably talking about maybe thousands of (undiagnosed) people,” says Dave Hovda, director of UCLA’s Brain Injury Research Center, who has worked with the military on brain treatment. “Either we didn’t know about, or we didn’t capture them early enough to protect them so they wouldn’t develop (more serious) problems.”

There is stark difference between how the military uncovers brain injuries today compared with even three years ago, says Michael Kilpatrick, a Pentagon health official.

In the early years of both wars, troops were rarely pulled aside and examined for signs of a concussion after being exposed to a roadside blast. Military science has since learned that concussions were not uncommon, and that if the brain injury was not allowed time to heal, a second exposure to a blast could cause permanent damage.

During 2005 and 2006, the average of number of brain-injury diagnoses recorded in Iraq and Afghanistan was only a few hundred every three months. Beginning in 2010, the Pentagon instituted medical rules requiring any soldier caught near a blast to be examined for signs of a concussion — dizziness, problem-solving difficulties, visual light-sensitivity and headaches — and kept out of combat until the symptoms disappear.

The military started uncovering hundreds more cases, data show. Nearly a thousand traumatic brain injuries, the vast majority of them mild, were diagnosed every three months in 2010, and the rate was nearly 1,200 per quarter last year.

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