• In earlier wars, many soldiers receiving head injuries did not survive because of wounds to other parts of their bodies. Today, modern body armor allows more soldiers with head injuries to survive.
• Better field hospitals and faster trauma treatment also improve survival rates for severely injured soldiers, allowing more of those with brain injuries to return home.
• Explosive devices are the enemy’s favorite weapon and the most common cause of concussive brain injuries. Injury occurs not only from the blast itself, but also from flying objects striking the head, and from the impact of the head striking something after the body is flung through the air by the blast.

Types of TBI

Traumatic brain injuries generally fall into either of two categories.

• Closed head injury. In a closed head injury, there is no physical sign of injury to the head other than possibly a bump or bruise.
• Open or penetrating head injury. A visible head wound clearly identifies an open or penetrating head injury.

TBI is also classified according to severity.

• Mild TBI.  Someone with a mild TBI will typically recover fully within one year.
• Moderate TBI. Those suffering moderate TBIs will recover to some degree but have lingering mental and/or emotional deficits, usually for the remainder of their lives. Nonetheless, they may seem normal to others who do not know them well.
• Severe TBI. A severe TBI is accompanied by noticeable mental and/or emotional disability, and sometimes physical disability as well.

How War TBI Goes Undiagnosed

TBI is always suspected when there is a visible head wound. Soldiers with obvious head wounds are routinely screened for the effects of brain injury.

But those who have experienced a TBI from a closed head injury may not be diagnosed. This type of injury can be caused by whiplash or any similar sudden movement of the head that causes the brain to violently strike the inside of the skull.  A closed head injury can occur not only in an explosive blast, but also from a fall or a vehicle accident, or from a flying object striking the helmet.

TBI symptoms vary depending on the part of the brain that is affected and the type and severity of the injury. Symptoms can be a mixture of difficulties related to:

· Cognitive impairment – Reduction in intellect, memory, reasoning, math or language skills
· Behavioral issues – Anger, self-centeredness, aggressiveness, inappropriate behaviors
· Emotional problems – Depression, apathy, low self-esteem, social withdrawal, irritability

Complicating the diagnosis of TBI is the fact that some of these symptoms can be attributed to post-traumatic stress disorder (PTSD), effectively masking the existence of the brain injury.

A mild or moderate TBI is especially likely to go undiagnosed if the victim suffers no other physical wounds that would lead to being seen or evaluated by a doctor.

With so many Iraqi War and Afghan War veterans suffering catastrophic injuries and amputations, it is difficult for a veteran with a closed head TBI to compete for government medical services. In fact, even those veterans who suffered devastating open head injuries with obvious TBI are having a difficult time obtaining rehabilitation services through the Veterans Administration. Some seriously wounded have waited up to six months, and others are still waiting.

What to Do

If you are experiencing problems with thinking or memory, or emotional or behavioral problems after serving in Iraq or Afghanistan, read the following two articles to see how those problems compare to the symptoms of TBI.

• Cognitive Impairment in Brain Injury Cases
• Emotional Symptoms Following a Brain Injury

If the symptoms seem to indicate the possibility of a TBI, try to recall when you may have received a blow to the head or experienced a violent head motion.  Be aware, however, that it is not uncommon for someone who received a closed head injury to be unable to remember the event that caused it.  If you don’t recall an event that may have caused an injury to your head, do you recall a time when you felt confused or suffered from a headache and were unable to remember what happened immediately beforehand? Any such recollection can help substantiate the possible existense of a TBI.

If your symptoms are mild, you’ll probably recover fully after several months to a year following the injury.

For more bothersome symptoms, however, you should see a physician. Sometimes, the signs of a TBI can be seen on an MRI or CT scan, but not always. Doctors also have ways to test for thinking or memory problems or evaluate psychological and behavioral problems to arrive at a diagnosis of TBI.

If you have a TBI, it’s important to acknowledge it and obtain assistance. Various types of therapies can help you learn how to compensate for many of the effects of TBI and resuming leading a productive and happy life.

Related Articles

• Recovery and Rehabilitation
• 1st Carnival of Hope for TBI Survivors
• Brian’s Story

These stories of hope are for those who have been recently injured and for their friends and caregivers.  Though the stories are different, they are in some ways the same.  Reading them may help prepare you for the challenges ahead in adapting to the side effects of TBI.

The majority of traumatic brain injuries occur in motor vehicle accidents, but not Jean Anderson’s. She was at a parade when a stampeding horse crashed into her from behind and sent her flying into the air to land on her head.  Jean talks candidly about her problems with emotions and cognition and the impact of her injury on her family in My Day at the Parade.

After motor vehicle accidents, falls are another common cause of head injury. Joan describes how slipping on a pebble on a sidewalk sent her into a long and lonely recovery.  She speaks eloquently of her heart-wrenching emotions during this time in My Life Has Changed.  

Continuing our theme of bucking the odds, Josh Schafer was injured as a teenager when fooling around with a friend who swung a door with great force, accidently hitting Josh in the head. Josh didn’t lose consciousness and was never diagnosed with an injury, but has nevertheless struggled with many of the common deficits associated with brain injury ever since. Josh talks about what it’s like to not be “normal” while simultaneously feeling that he doesn’t belong in the TBI community because his injury is mild compared to what many others have suffered.  He describes being in a virtual “no-man’s land” in his Mild Traumatic Brain Injury Blog.  

Kitty Kavey doesn’t dwell on the physical recovery from her motorcycle accident. Instead, her story begins with being abandoned as a child, continues to drugs and homelessness as a teenager, and ultimately ends with her adapting to her injuries and becoming a successful screenwriter, actress and model. Her’s is a fascinating story on her official web site KittyStar.com. 

Finally, there is Tracey Phillips. Tracie also suffered a head injury in a fall, in her case slipping on an icy walkway. Tracey describes well the sensory problems associated with her injury and how hard it was to remain positive during her initial recovery.  She ends her story reporting that four and a half years following her accident, she has landed a full time job at a legal firm. Read all about it at Homepage for Tracey.  

For additional stories, visit:

• 1st Carnival of Hope
• Brian’s Story

One such person is Brian.  He said I could use his last name, but I’m not going to. He’s a real person, all right – we chat on Facebook. And in a way that just serves to emphasize the possibilities people have after suffering devastating brain injuries.  When I mentioned that the Head and Brain Injuries website was featuring stories of hope for people who may be recently coping with recovery from a TBI, Brian offered this account of his injury and continuing recovery.

Brian’s Story

“Back in January, 1990, I was working in the oilfields of Northern BC, Canada. I was doing some standard maintenance on an oil well at a nice chill of minus 40 degrees. The line was plugged, so we were unplugging it.

“During the operation, the well blew up. (Through no fault of our own, just circumstances.) Parts of the wellhead flew by me, caving in my skull, and trapping me by the legs, while 3 miles of oil line depressurized onto me. It was a very horrific experience.

“Apparently I lost consciousness for about 1/2 hour. All I can remember is the helicopter landing to take me to the hospital (75 miles away), then another trip by jet to a major centre 800 miles away. I was covered from head to foot in crude oil (and smelling real bad of hydrogen sulfide gas).

“I was only in the hospital for about a week. Wow, short time you say? Well, it was, but from there my troubles were only beginning.

“I had swelling in the face (from the high pressure oil), teeth loosened, jaw and neck problems, hearing problems, slow left side, balance problems, poor short term memory, trouble understanding words, concentration problems, dyslexia, mood swings, depression, lack of sex drive (come to think of it, lack of any drive), and Post Traumatic Stress Disorder.

“The first year or so is just a blur of memory to me. It could have been from the heavy medications, or just my brain’s way of blocking the pain and shock. I could not remember even my wife’s or my pet dogs’ names!!!!

“People would speak to me. I could recognize the words, but I didn’t understand what they meant. I would get lost in sentences real easy, specially if the person used more than 10 words in a row. And I would lose all the meaning of the previous sentences if they just kept talking. It was a tough time.

“Over time I found that part of the problem was from damaged hearing on the left side. Signals from the ear to the brain were being scrambled. (That only showed up in a sophisticated computerized hearing test.)

“Over the years, I have had many different people helping with my rehab. I have had to relearn to read and do math. (That was a shock – going from an engineering status to not being able to do grade 3 math).

“I have learned to adapt to many of my problems – i.e. walking on soft ground, keeping my tasks to short duration, even how to pace myself at things so as to not overload my senses too much.

“I can still remember the pre-TBI days very clearly. Maybe that is bad, because I compare the deficits I have now too much with what and who I was. I am no longer the outgoing, hardworking achiever that I used to be.
 
“I am telling this because no doctors seem to tell you of all the troubles you might be up against. You lose many friends, and your family has a much heavier burden to carry caring for you.

“Roles in the family often have to switch without warning. Suddenly the wife, previously the homemaker, is forced into being the major breadwinner, and a caregiver at the same time.

“On the outside I look like an ordinary person, the scars hardly even show, but inside is much turmoil. Many of my old skills are not re-usable, the stamina does not allow it, the unclear thinking does not allow it, and yes, the lack of confidence in myself now does not allow it.
 
“Will I ever work again, I don’t know. Unforeseeable in the near future, and that is a major blow to my psyche.

“Yes, I have come a long way, and yes, there is further to go.”

Editor: Keep going, Brian. Just keep going! You inspire everyone who follows in your footsteps. Keep leaving those footprints.

For additional stories, visit:

• 1st Carnival of Hope
• 2nd Carnival of Hope

We are seeking first person stories from head injury victims or their loved ones describing successes, large or small, in recovering from traumatic brain injury. On April 2, 2009. we will publish links to a selection of the stories we receive.

Our 1st Carnival of Hope yielded emotional stories of tragedy and triumph – some just one page, poignant and brief, while others were longer and revealing of details in the recovery process. All of the stories sounded common themes of determination, acceptance, and the importance of friends and family. 

We want this carnival to be a testament to human resilience and the role of supportive family, friends, and caregivers in helping TBI survivors regain a significant part of themselves. To enter, your story must be already published somewhere on the web.  We will publish a link to your story and ask you to post a link back to us. To see what our blog carnival looks like, read our 1st Carnival of Hope.

We reserve the right to select or reject any submission for any reason whatsoever, but our hearts will favor believable stories that have the potential (in our sole opinion) for encouraging other TBI survivors to persevere in their recovery efforts.

To submit your story, use the the “submit an article” link at the bottom of the submission form at BlogCarnival.com.

Thank you, and God bless you.

After the initial worry-filled days or weeks in intensive care, when family and friends are praying for their loved one to just make it through the injury alive, survivors eventually go home to begin a long and often difficult journey through recovery and rehabilitation.

For those who are just beginning that journey, we bring you stories of hope – stories of other TBI survivors who have had to rebuild their lives around the reality of their injury, but who have gone on to live their lives anyway.  In some of these stories, you may hear of the highs and the lows, the successes and the crashes – there is no sugar coating.  But you will also hear the common themes of determination, acceptance, and the importance of friends and family. 

Reading these stories, you’ll discover each one is different, and yet they are all the same.  They tell us it is indeed possible to write your own story and attain a life that is fulfilling in your own unique way.

Take Kelly Sanders for example. After her injury, she went on to begin a successful career in massage therapy. Read about Kelly’s recovery at KellyGirlTN. Be sure to click on her AboutMe page. What Kelly doesn’t mention on her website, however, is that she was recently appointed by the governor of Tennessee to a two-year term on the state’s TBI Advisory Council. Congratulations, Kelly!

From a different point of view comes Betsy’s story of the TBI her 72-year-old mother suffered, and how at 80, Mom now stays involved with book groups, theater and friends. As her mother’s caregiver, Betsy can be credited with much of her mom’s successful recovery. Her website gives a very detailed account of the injury and the many steps taken on the long road to healing. Read Betsy’s Support Site for Traumatic Brain Injury Recovery and Rehabilitation.

Here’s one you don’t see very often. Elsiha Jensen writes poetry – pretty good poetry, actually. Through his poems you’ll catch glimpses of life through his eyes after his accident. Visit Elisha’s site, Newer Stuff From My Head.

In July 2000, Army Sgt Chris Lynch spent 24 days in a coma after falling 2 1/2 stories onto his head during a military training exercise in France.  Over the following 8 years, Sgt lynch chronicled his rehabilitation and recovery, year by year. Read more about Chris at Welcome to Chris’ Web. For his latest update, jump ahead to Page 19. Don’t foget to click on the arrows under the photos to see more.

On her one-page personal website, Cortney Wells describes feeling as though she could never go to college following her TBI in high school. Today, she has a degree and a job as a dental assistant. Cortney says, ” What I want you to get out of this story is that you should NEVER give up!!”

In a much longer account, Barbara Jean chronicles her 10-year journey in recovery after her stopped 18-wheeler was rear ended by another semi traveling at full speed. Read more at BJs Closet.

In her brief post, Denise Fury describes “the surviving, the fighting, the crying, the growing up” involved in her 5 years of recovery, and her next steps. Read Denise’s Page.

And in the “Famous People” category is this interview with Lee Woodruff submitted by Alvaro Fernandez. Lee’s husband, well-known national TV reporter Bob Woodruff, was brain-injured by a roadside bomb in Iraq in January 2006.  In August 2008, Bob was back at work interviewing Presidential contender John Edwards on national TV.  Read all about Bob’s remarkable recovery. 

There are many, many more stories of hope and recovery we can bring you, but I think these are enough for now.  We’ll save some for our next Carnival April 2nd.

If you know of any other stories of hope that would be helpful or inspiring to new TBI survivors, please leave us your comment below, or if you prefer, email me. And if you enjoyed this Carnival, please share it with others.

Thanks Everyone,

Steve Holder
Writer/Editor

For additional stories, visit:

• 2nd Carnival of Hope
• Brian’s Story

We are seeking first person stories from head injury victims or their loved ones describing successes, large or small, in recovering from traumatic brain injury. On March 1st, 2009. we will publish links to a selection of the stories we receive.

We want this carnival to be a testament to human resilience and the role of supportive family, friends, and caregivers in helping TBI survivors regain a significant part of themselves. To enter, your story must be already published somewhere on the web.  We will publish a link to your story and ask you to post a link back to us.

We reserve the right to select or reject any submission for any reason whatsoever, but our hearts will favor believable stories that have the potential (in our sole opinion) for encouraging other TBI survivors to persevere in their recovery efforts.

To submit your story, use the the “submit an article” link at the bottom of the submission form at BlogCarnival.com.

Thank you, and God bless you.

Trauma to the brain results in many mood and behavior problems. Depression is frequently cited after a mild head injury due to frustration and loss of self esteem.

Individuals suffer a mild brain injury whenever they are hit on the head, strike their head against an immovable object, or have had their brain strike against the inside of the skull due to whiplash or shaking. Motor vehicle accidents are a leading cause of head injury, but brains are frequently rattled in athletic events and as a result of fights and abuse. Brain or head injury is an under-reported youth sports injury.

Head injuries cause changes in mood and behavior that are noticeable to the injured. Others may view them as irritable and aggressive. The head-injured frequently endure panic attacks and depression. As the individual notices emotional and cognitive changes and struggles to control his feelings, frustration is often the result. Frustration may become so strong that the person feels like he is “losing his mind.” He becomes moody and depressed, and if left untreated his depression may spiral downward dangerously.

Doctors are becoming increasingly aware of the fact that depression lingers on after the physical cuts, bruises, and broken bones are healed. As a result, more are emphasizing the importance of including neurological rehabilitation after any bump to the head or rattle of the brain. An important aid to recovery is patient understanding and acceptance of the injury. The head-injured person has to learn not to get mad at others and himself about every event that “pushes his emotional button”.

Two Strategies to Prevent Depression’s Pull

Take control of emotions by taking a time-out when emotions rise to the surface. Get away from whatever is irritating by taking a walk or turning attention to something that is pleasing. It takes a lot of practice, but if the head-injured person sees this practice as critical to his rehabilitation he will stick to it and train himself to “get a grip” rather than explode.

Loss of language skill is another frequent brain injury trait that sparks a loss of self esteem. This can be devastating, especially to the individual who has achieved pre-injury success in a profession or leadership position. Everyone has that moment when they can’t think of the right word, but the brain-injured suffer this problem more often. The brain-injured have to work hard to “keep talking” until they find the word and not give up or think they are dull minded. Talking about it can help. Visualize the first letter, the color, or some other characteristic of the word.

You Can Do It!

Brain injury shouldn’t rob a person of true emotions and self esteem. If you are brain injured or are the caregiver of a brain-injured person, seek out doctors who understand brain injury and will support your needs. See a neuropsychologist for testing. Families and close friends need to be educated in brain injury and the thinking-related deficits that result from a rap on the head. Work together to recognize and gain control in order to prevent depression, which if left untreated may spiral downward and lead to more serious issues. The brain injured may need to take antidepressants if prescribed and never overlook the healing power of a healthy diet and exercise to keep the body … and mind … in shape.

This article was originally published by Sara E. Lewis at Suite101.com

Related Articles

• Living with Brain Injury – Post-Rehabilitation Recovery
• Emotional Symptoms Following a Brain Injury
• Overview of the Traumatic Brain Injury Recovery Process

Pittsburgh Steeler star quarterback Ben Roethlisberger suffered a concussion during the final game of the 2008 regular season, giving the team and fans quite a scare. After being wrapped up by two Cleveland Brown defenders at the end of a second-quarter play, Roethlisberger fell backward slamming his head hard on the turf.

The stadium fell quiet as Roethlisberger lay motionless for all of 10 minutes while trainers cut his helmet apart to remove it. Although he said the blow robbed him of feeling in his arms and he couldn’t feel being transferred to a stretcher when he was moved from the field, subsequent evaluation graded it a “mild” concussion – Roethlisberger’s third in three seasons.

Dr. Joseph Maroon at the University of Pittsburgh Medical Center – leader of the Steelers’ concussion management team – reports that the NFL concussion protocol requires an injured player to pass coordination and memory testing and be symptom-free for 15-minutes, including after physical exertion before being allowed to return to play. Players with anything other than a mild concussion usually don’t pass these tests and are not allowed to return to the game. This is considered typical concussion management protocol for professional athletes.

But not being satisfied with adhering to the minimum standards, Dr. Maroon’s neurosurgical team has developed a computerized test – the ImPACT test – that can provide a detailed evaluation of even the most minor symptoms resulting from a concussion. Steelers players take the test at the beginning of the season for a baseline to compare against in the event anyone is later injured.

After a suspected concussion, the player takes the ImPACT test, usually the next day. The computer test measures attention span, memory, mental processing speed, and reaction time down to 1/100 of a second. If the test results show a worrisome decline in performance, the player is not allowed to practice until the symptoms resolve.

This policy is to help Steelers players avoid not only a debilitating and potentially fatal second injury, but also to help prevent them developing chronic traumatic encephalopathy, which is a form of dementia resulting from repeated blows to the head. This is an issue for the team because of the five NFL players determined to have died before age 51 of causes related to this type of accumulated brain damage, three of them were Pittsburgh Steelers – Mike Webster, Terry Long, and Justin Strzelczyk.

As for Roethlisberger, the Steelers had two weeks off before meeting the San Diego chargers in a divisional playoff game, giving the Steelers QB plenty of time to recover.  Several days before the game, Roethlisberger reported he was feeling all back to normal.

Related Articles

• Brain Injuries in Sports
• NFL Concussions: Brandon Stokely
• Concussion Management in Organized Sports
• Understanding Post-Concussion Syndrome

In the final minutes of the first quarter, he gathered in another pass and took a minor bump to the helmet that left his legs wobbly. Brandon fell to his knees, and then left for the remainder of the game.

By his own admission, this was not his first concussion. Not counting a serious concussion in college, he counts 7 minor and 3 serious concussions during his 10-year NFL career. If he truly understood the seriousness of a concussion, and how a second rapid-fire head injury can cause uncontrollable brain swelling and death, Brandon Stokely would be thankful he’s even still alive.

Unfortunately, the competitive nature of sports entices players to downplay their injuries so they can continue competing. Double unfortunately, this leads to many players having short careers and short lives. For the sake of Brandon’s 4-year-old son, we hope he realizes how serious these head injuries can be and takes appropriate care of himself.

Related Articles

• Brain Injuries in Sports
• NFL Concussions: Trent Edwards
• Concussion Management in Organized Sports
• Understanding Post-Concussion Syndrome

Fourteen days later, however, Edwards seemed to be none the worse for wear as he managed to lead the Bills to a 23-14 win against the San Diego Chargers, completing 25 of 30 passes and a touchdown.

After being hit in the Arizona game’s third play, Edwards lay on the field for several minutes before being helped up and assisted off the field by trainers. It was reported that he had no memory of events for about 15 minutes following the blow, and suffered a headache for several days. Loss of consciousness, loss of memory, and headache are clear signs of a concussion, if not something worse.

NFL rules require any player experiencing a concussion not be allowed to return to play the same day. Further, the player must have no continuing concussion symptoms and exhibit normal neurological and mental test results at rest and after exertion before returning at all. Otherwise, the situation is left up to the team and its physicians.

The NFL guidelines contrast with National Hockey League rules requiring a player with a concussion not practice or play for seven days. According to the concussion management guidelines of the American Academy of Neurosurgeons (AAN), a player suffering a concussion resulting in a loss of consciousness should not be allowed to play for at least one or two weeks, and then only if mental function is completely normal.

Though their concussion protocol was not detailed, the Buffalo Bills kept Edwards from practicing until the eighth day following his injury, which seems to adhere more closely to the AAN guidelines. It also seems a wise policy given the results against the Chargers on Edwards’ return to competition.

Related Articles

• NFL Concussions: Brandon Stokely
• Understanding Post-Concussion Syndrome
• Brain Injuries in Sports