thedrifter
04-29-07, 08:19 AM
Published: 04.29.2007
Troops, docs grope for handle on mild injuries to the brain
By Catherine Clabby
MCCLATCHY NEWSPAPERS
RALEIGH, N.C. — Marine Gunnery Sgt. Bill Rosborough recalls with excruciating clarity when a water truck smashed into the building where he was preparing an Iraqi Army payroll.
Explosives inside the truck vaporized the wall of his office in Al Kasik, vaulting him into the air. Shards of glass cut him, and building parts crushed him.
Back at Camp Lejeune three years later, many of his visible wounds have been patched. But his brain still isn't right.
"I was able to do a million things before. Now I walk in the grocery store and I can't remember why I went," he said.
Rosborough, 36, works in the Wounded Warrior Barracks at Camp Lejeune, where injured Marines stay before returning to duty or leaving the military.
The military, faced with relentless bomb attacks on U.S. forces, in its latest survey estimates that as many as one in five soldiers and Marines will suffer "mild" brain injuries in Iraq.
Seventy percent are better by the time they return stateside, but for others symptoms persist.
As military and veterans' doctors confront what some call the signature wound of this war, they find more questions than answers. Diagnosing mild brain injuries is not simple. And the best treatments aren't yet clear.
"We're still trying to figure out exactly what this injury is, what exactly is the problem in the brain," said Col. Jonathan Jaffin, acting commander of the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md.
Symptoms include short-term memory loss, faulty concentration, irritability, changed vision and headaches, among others. And problems vary from person to person. On top of that, brain injuries can be mistaken for other disorders such as post-traumatic stress disorder or substance abuse.
Technology can't yet clarify matters. Mild brain injuries rarely get detected on MRIs and other imaging tools.
In North Carolina, Veterans Affairs mental health researchers are trying to sharpen the picture. At the W.G. Hefner Medical Center in Salisbury, doctors will take MRI scans of veterans who were and were not exposed to explosions, including those with brain-injury symptoms and those without. They hope patterns of differences will emerge.
They are collaborating with researchers at the Massachusetts Institute of Technology. Scientists there are using laboratory studies with brain tissue and computers to better predict how the force of an explosion affects various parts of the brain.
What happens isn't clear, Jaffin said. It is known that explosions damage air-filled portions of the body, especially the lungs and areas inside the ear. But the precise effects on the soft tissue of the brain is unknown.
"We know the explosions cause the problems. But whether it's the blast pressure or whether a vehicle gets flipped over and a guy gets flipped onto his head, it's hard to separate that out," Jaffin said.
In Salisbury, researchers are also trying to sort out differences between patients with brain injuries and those with post-traumatic stress disorder.
"They can look the same, but we're looking for distinctions," said Dr. Robin Hurley, a neuropsychiatrist.
Ellie
Troops, docs grope for handle on mild injuries to the brain
By Catherine Clabby
MCCLATCHY NEWSPAPERS
RALEIGH, N.C. — Marine Gunnery Sgt. Bill Rosborough recalls with excruciating clarity when a water truck smashed into the building where he was preparing an Iraqi Army payroll.
Explosives inside the truck vaporized the wall of his office in Al Kasik, vaulting him into the air. Shards of glass cut him, and building parts crushed him.
Back at Camp Lejeune three years later, many of his visible wounds have been patched. But his brain still isn't right.
"I was able to do a million things before. Now I walk in the grocery store and I can't remember why I went," he said.
Rosborough, 36, works in the Wounded Warrior Barracks at Camp Lejeune, where injured Marines stay before returning to duty or leaving the military.
The military, faced with relentless bomb attacks on U.S. forces, in its latest survey estimates that as many as one in five soldiers and Marines will suffer "mild" brain injuries in Iraq.
Seventy percent are better by the time they return stateside, but for others symptoms persist.
As military and veterans' doctors confront what some call the signature wound of this war, they find more questions than answers. Diagnosing mild brain injuries is not simple. And the best treatments aren't yet clear.
"We're still trying to figure out exactly what this injury is, what exactly is the problem in the brain," said Col. Jonathan Jaffin, acting commander of the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md.
Symptoms include short-term memory loss, faulty concentration, irritability, changed vision and headaches, among others. And problems vary from person to person. On top of that, brain injuries can be mistaken for other disorders such as post-traumatic stress disorder or substance abuse.
Technology can't yet clarify matters. Mild brain injuries rarely get detected on MRIs and other imaging tools.
In North Carolina, Veterans Affairs mental health researchers are trying to sharpen the picture. At the W.G. Hefner Medical Center in Salisbury, doctors will take MRI scans of veterans who were and were not exposed to explosions, including those with brain-injury symptoms and those without. They hope patterns of differences will emerge.
They are collaborating with researchers at the Massachusetts Institute of Technology. Scientists there are using laboratory studies with brain tissue and computers to better predict how the force of an explosion affects various parts of the brain.
What happens isn't clear, Jaffin said. It is known that explosions damage air-filled portions of the body, especially the lungs and areas inside the ear. But the precise effects on the soft tissue of the brain is unknown.
"We know the explosions cause the problems. But whether it's the blast pressure or whether a vehicle gets flipped over and a guy gets flipped onto his head, it's hard to separate that out," Jaffin said.
In Salisbury, researchers are also trying to sort out differences between patients with brain injuries and those with post-traumatic stress disorder.
"They can look the same, but we're looking for distinctions," said Dr. Robin Hurley, a neuropsychiatrist.
Ellie