Military personnel who have exposed to blasts often exhibit signs and symptoms of brain injury…and yet the results of MRI and CT scans appear normal. It has been puzzling for physicians.
Now, The New York Times reports that a highly sensitive type of magnetic resonance imaging is able to show evidence of subtle brain injuries, damage specific to blast injuries. The injuries are poorly understood, and sometimes produce lasting mental, physical and emotional problems.
“This sort of mild traumatic brain injury has been quite controversial,” said Dr. David L. Brody, an author of the new study and an assistant professor of neurology at Washington University in St. Louis. “Is it due to structural abnormalities in the brain, chemical dysregulation, psychological factors or all three? We show that at least in some there are structural abnormalities.”
The pattern of the damage differed from that found in head injuries not caused by blasts, and matched computer simulations predicting how explosions would affect the brain, Dr. Brody said. If the new findings hold up, he added, they may eventually influence the design of helmets to provide more protection against blasts.
The injuries were discovered with a special MRI technique called “diffusion tensor imaging.” It measures the movement of water in nerve fibers in the brain; abnormal water movement suggests injury to those delicate nerve fibers.
Katherine Helmick, deputy director for traumatic brain injury at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, said the Defense Department was eager for information that would “help us understand what blast is doing to the brain, and help us get what we really want in diagnosing traumatic brain injury, which is objective markers.”
Victims also want the new technique to work. Veterans who experience blast trauma can be left with problems involving speech, memory, balance, and thinking…but without objective medical evidence of brain damage, they may not receive the treatment they need. They also may not be believed, and could end up with occupational and relationship difficulties.
The scans are still in development, but everyone hopes they will be found to be a useful tool. If diffusion tensor imaging is proved to be a reliable and valid diagnostic tool for blast injuries, the next step will be to prove its value for other types of subtle brain trauma–the kind caused by auto wrecks, blows to the head, falls, or other types of personal injury. We’re looking forward to having another way to help our brain injured clients get the medical and legal help they need.
To read an abstract of the original study, click here: Detection of Blast-Related Traumatic Brain Injury in U.S. Military Personnel
To read the full article in The New York Times, click here: Brain Injuries Are Seen in New Scans of Veterans
