Team Infidel
Forum Spin Doctor
New York Times
September 1, 2008
Pg. 16
To the Editor:
Re “Home From War, Veterans Say Head Injuries Go Unrecognized” (front page, Aug. 26):
Brain injuries are a signature issue of the Iraq and Afghanistan conflicts, and tests to detect them are limited, leading to many troops’ conditions being misdiagnosed or undiagnosed as they return home from combat. Yet there is hopeful news on the horizon.
The Brain Trauma Foundation, with the support of the Department of Defense, is developing a hand-held eye-tracking device that will enable military personnel to determine within seconds — on the battlefield — if a soldier has been subjected to a traumatic brain injury, a condition that has been historically difficult to detect.
This important new technology will allow for even faster and more appropriate treatment and, ultimately, better outcomes for the thousands of men and women serving our country on the front lines.
Jamshid Ghajar, New York, Aug. 27, 2008
The writer, a neurosurgeon, is president of the Brain Trauma Foundation.
***
To the Editor:
Several months before my arrival in Iraq in 2007, the unit I was assigned to, the 206th Area Support Medical Company of the Missouri Army National Guard, was one of the first to follow the Army’s new policy requiring every soldier exposed to improvised explosive devices to be evaluated for traumatic brain injury as soon as conditions allowed.
In short order, the men and women of the unit became proficient in diagnosing and treating these soldiers’ injuries. And unlike the soldier cited in your article, most of the soldiers suffering moderate to severe concussions due to combat action were recommended for and received the Purple Heart.
Our newfound ability to document and track these injuries confronted us with the same dilemma faced by athletes and others with repeated brain injuries: how many concussions are too many? It was not unusual for many of the service men and women in our area to be exposed to as many as 10 to 15 I.E.D.’s in a 12-month tour. We had no data to guide us and knew that only time and close follow-up would answer the questions as to delayed onset symptoms from repeated injuries.
For the sake of the individual soldier as well as the ability to protect and maintain an operational force, no one is more interested in finding the answers to these questions than the Army.
Gary R. Brickner, Princeton, N.J., Aug. 26, 2008
The writer is a major in the New Jersey Army National Guard Medical Corps and served in Afghanistan in 2004 and Iraq in 2007.
***
To the Editor:
With regard to head injuries in veterans, I’d like to add another frequently unrecognized, but eminently treatable, possible consequence of traumatic brain injury: post-traumatic epilepsy. This disorder can manifest itself as subtle seizures characterized by a variety of difficult-to-recognize symptoms including periodic alterations in awareness, or changes in personality and behavior, or difficulty with memory.
These can develop months or even years after the inciting trauma. The symptoms may be misdiagnosed as cognitive changes due to the head injury, or even psychiatric symptoms. If recognized as seizures, the symptoms can be treated with anti-epileptic drugs.
Professionals in the epilepsy care community have been very concerned that veterans with subtle post-traumatic epilepsy may “fall through the cracks” of medical care. The American Epilepsy Society has created an Operation Giveback task force (of which I am chairman) to increase awareness of this condition among veterans, their families and the Veterans Administration, to provide educational materials via the society’s Web site and to support enhanced epilepsy services to our injured veterans.
Marc A. Dichter, Philadelphia, Aug. 26, 2008
The writer is a professor of neurology and pharmacology at the University of Pennsylvania School of Medicine.
September 1, 2008
Pg. 16
To the Editor:
Re “Home From War, Veterans Say Head Injuries Go Unrecognized” (front page, Aug. 26):
Brain injuries are a signature issue of the Iraq and Afghanistan conflicts, and tests to detect them are limited, leading to many troops’ conditions being misdiagnosed or undiagnosed as they return home from combat. Yet there is hopeful news on the horizon.
The Brain Trauma Foundation, with the support of the Department of Defense, is developing a hand-held eye-tracking device that will enable military personnel to determine within seconds — on the battlefield — if a soldier has been subjected to a traumatic brain injury, a condition that has been historically difficult to detect.
This important new technology will allow for even faster and more appropriate treatment and, ultimately, better outcomes for the thousands of men and women serving our country on the front lines.
Jamshid Ghajar, New York, Aug. 27, 2008
The writer, a neurosurgeon, is president of the Brain Trauma Foundation.
***
To the Editor:
Several months before my arrival in Iraq in 2007, the unit I was assigned to, the 206th Area Support Medical Company of the Missouri Army National Guard, was one of the first to follow the Army’s new policy requiring every soldier exposed to improvised explosive devices to be evaluated for traumatic brain injury as soon as conditions allowed.
In short order, the men and women of the unit became proficient in diagnosing and treating these soldiers’ injuries. And unlike the soldier cited in your article, most of the soldiers suffering moderate to severe concussions due to combat action were recommended for and received the Purple Heart.
Our newfound ability to document and track these injuries confronted us with the same dilemma faced by athletes and others with repeated brain injuries: how many concussions are too many? It was not unusual for many of the service men and women in our area to be exposed to as many as 10 to 15 I.E.D.’s in a 12-month tour. We had no data to guide us and knew that only time and close follow-up would answer the questions as to delayed onset symptoms from repeated injuries.
For the sake of the individual soldier as well as the ability to protect and maintain an operational force, no one is more interested in finding the answers to these questions than the Army.
Gary R. Brickner, Princeton, N.J., Aug. 26, 2008
The writer is a major in the New Jersey Army National Guard Medical Corps and served in Afghanistan in 2004 and Iraq in 2007.
***
To the Editor:
With regard to head injuries in veterans, I’d like to add another frequently unrecognized, but eminently treatable, possible consequence of traumatic brain injury: post-traumatic epilepsy. This disorder can manifest itself as subtle seizures characterized by a variety of difficult-to-recognize symptoms including periodic alterations in awareness, or changes in personality and behavior, or difficulty with memory.
These can develop months or even years after the inciting trauma. The symptoms may be misdiagnosed as cognitive changes due to the head injury, or even psychiatric symptoms. If recognized as seizures, the symptoms can be treated with anti-epileptic drugs.
Professionals in the epilepsy care community have been very concerned that veterans with subtle post-traumatic epilepsy may “fall through the cracks” of medical care. The American Epilepsy Society has created an Operation Giveback task force (of which I am chairman) to increase awareness of this condition among veterans, their families and the Veterans Administration, to provide educational materials via the society’s Web site and to support enhanced epilepsy services to our injured veterans.
Marc A. Dichter, Philadelphia, Aug. 26, 2008
The writer is a professor of neurology and pharmacology at the University of Pennsylvania School of Medicine.