New Protocol to Provide Early Brain Injury Detection

By Christen N. McCluney
Special to American Forces Press Service

WASHINGTON, March 16, 2010 – The Defense Department is rolling out a new set of guidelines for the treatment of mild traumatic brain injury among servicemembers in combat areas.   “We’re morphing from a symptom-based approach in theater to an incident-based approach,” a senior official said yesterday during a “DoDLive” bloggers roundtable.   “The tenet behind this is we strongly believe that early detection and early treatment decrease the complaints of post-traumatic brain injury after sustaining an injury,” said Kathy Helmick, interim senior executive director for traumatic brain injury and director of TBI clinical standards of care at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.   The new protocol will go into effect soon and will make head injury evaluations mandatory for servicemembers who have been involved in incidents such as being close to explosions or blasts. In the past, Helmick explained, servicemembers simply decided for themselves whether to report symptoms. Moving forward, the medical staff will check everyone involved in such incidents.    read more


2 studies: PTSD is chemical change in brain

By Kelly Kennedy – Staff writer
Posted : Thursday Dec 10, 2009 6:26:52 EST

Two new studies seem to provide more evidence that post-traumatic stress disorder is a chemical change in the brain caused by trauma — and that it might be possible to diagnose, treat and predict susceptibility to it based on brain scans or blood tests.  In one study, Christine Marx, of the Duke University Medical Center and Durham Veterans Affairs Medical Center, wondered why PTSD, depression and pain often occur together.  Researchers already knew that people with PTSD show changes in their neurosteroids, which are brain chemicals thought to play a role in how the body responds to stress.  Previous animal studies showed that blood neurosteroid levels correlated to brain neurosteroid levels, so Marx measured the blood neurosteroid levels of 90 male Iraq and Afghanistan veterans. She found that the neurosteroid levels correlated to symptom severity in PTSD, depression and pain issues, and that those levels might be used to predict how a person reacts to therapy as well as to help develop new therapies.  Marx is researching treatment for people with traumatic brain injuries using the same kind of brain chemical, and early results show that increasing a person’s neurosteroid level decreases his PTSD symptoms.  read more

Veterans and Shelter Animals Meet With Pets2Vets

By LINDA LOMBARDI For The Associated Press
WASHINGTON December 21, 2009 (AP)

Dave Sharpe was troubled by thoughts he couldn’t share after he returned from serving in Iraq. “I found myself waking up in the middle of the night, punching holes in walls, kicking and beating the refrigerator door,” he said.  Then one day, the former Air Force senior airman went with a friend to a local pit bull rescue and took home a puppy, Cheyenne. Next time he found himself kicking something, “I saw this puppy, cocking her head, looking up at me, like, what are you doing?”  Finally, Sharpe had someone he could open up to. “I froze, I put down my drink, I picked her up and laid with her in my bed,” he said. “I cried and I told her the whole story. I didn’t feel judged.”  The experience inspired Sharpe, of Arlington, Va., to start Pets2Vets, a group that pairs veterans with homeless pets by arranging adoptions of shelter animals. It has made two or three matches a week since its start in October. One of the goals of Pets2Vets is to raise awareness about post-traumatic stress disorder. Sharpe says that while a few groups provide veterans with service dogs, many PTSD and traumatic brain injury patients don’t qualify for these programs. Even when they do, because of the stigma still attached to psychological problems, they may hesitate to apply.

Army helps vets with `invisible wounds’ — brain injuries, PTSD — find jobs; employers hesitate

Associated Press
11/17/09 4:30 PM EST

SAN ANTONIO — Richard Martin keeps a rearview mirror on his desk to prevent co-workers from startling him in his cubicle. The walls are papered with sticky notes to help him remember things, and he wears noise-canceling headphones to keep his easily distracted mind focused.  Martin, an Army veteran who was nearly blown up on three occasions in Iraq, once feared that post-traumatic stress disorder and a brain injury would keep him from holding down a civilian job, despite years of corporate experience and an MBA.  “Here I am with this background and I’m having problems with my memory,” said Martin, a 48-year-old engineer and former National Guard major who now works for Northrop Grumman, helping to devise ways to thwart remote-detonated bombs.  The defense contractor recruited him through its hiring program for severely wounded veterans of Iraq and Afghanistan. The company consulted occupational nurses on how to help him do his job without becoming overly nervous when someone, say, drops a heavy object. Martin figured out other tricks, like the headphones, on his own. But Martin is one of the lucky ones.  Army officials say many new veterans suffering from PTSD and brain injuries struggle to find and keep a civilian job. Advocates say many employers don’t know how to accommodate veterans with these “invisible wounds” and worry that they cannot do the job and might even “go postal” someday.  “There is a stigma attached to the invisible wounds, and it’s largely borne out of ignorance,” said David Autry, a spokesman for Disabled American Veterans. “There’s a fear that somebody will go off the deep end.”  The Army’s Wounded Warrior Program, which helps veterans adjust to civilian life, has been reaching out to employers to educate them and encourage them to hire former soldiers with invisible wounds.  It conducts briefings to brace potential employers for soldiers who might not be able to work regular hours or might startle too easily, suffer outbursts or require time off for counseling.  About 90 severely wounded veterans have found work with the help of the Wounded Warrior Program since it began offering job assistance last year, though the Army does not break that down by injury type.

Researchers Discuss Limitations Of Prevalence Estimates Of TBI And PTSD Among OIF/OEF Veterans

Article Date: 05 Nov 2009 – 10:00 PST

In a special guest editorial, Bass and colleagues discuss the limitations of current estimates of the prevalence of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) among Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) veterans. Since these estimates often determine the allocation of resources, the authors urge decision makers to understand the limitations of these prevalence estimates.   The authors discuss three main problems with the current prevalence rates of TBI and PTSD in the OIF/OEF population. First, the studies generally report the percentage of servicemembers who screen positive for TBI or PTSD, not those who have been diagnosed with the condition by an appropriately trained medical provider. Second, the study samples are not representative of the entire ever-deployed military population. Third, the degree of impairment for servicemembers who have or have had TBI or PTSD is unknown.

VA let us down, says soldier’s mom

By Rick Maze – Staff writer
Posted : Wednesday Sep 16, 2009 16:35:14 EDT

The mother of a severely wounded Army veteran choked back tears Wednesday as she told attendees of a seminar on veterans’ health care that she believes the government has let her and her son down.   “It is very sad this country has let us down so incredibly,” said Leslie Kammerdiener, mother and caregiver of Army Cpl. Kevin Kammerdiener, a 173rd Airborne Brigade soldier who suffered severe burns and brain injuries in a 2008 roadside bomb explosion in Afghanistan.   A low point came earlier this year, Kammerdiener said, when her son indicated by hand movements that he wanted to hang himself. She said she called the Veterans Affairs Department asking for help because her son was suicidal; she waited days but got no return call.   She got help only after tracking down a doctor at a military event and pleading for help, she said.   Kammerdiener told her story at an Alexandria, Va., conference sponsored by the Military Officers Association of America and the U.S. Naval Institute that focused on what the government is doing and should be doing to help combat veterans with invisible wounds such as post-traumatic stress and traumatic brain injuries.  Kammerdiener had high praise for the immediate care her son received for his burns at the Brooke Army Medical Center in Texas. But once her son was transferred, care began to erode, she said.

Mild Traumatic Brain Injury Research

STAND-TO! Edition: Tuesday, June 23, 2009

What is it?

According to the Joint Theater Trauma System, 66 percent of the warfighters wounded in Operation Iraqi Freedom are from blast injury. Forty-one percent of the warfighters exposed to a blast show evidence of a traumatic brain injury.   Mild TBI is currently defined by the event and through self-report of symptoms. The working definition is any post-event exposure alteration of mental state at the time of injury, any loss of consciousness lasting 30 minutes or less, or post-traumatic amnesia lasting less than 24 hours. There is agreement that this definition does not meet the needs for clinical assessment of brain injury.