Brain Injury Awareness To Improve Readiness

• An estimated 449,026 service members have been diagnosed with a first-time TBI since 2000.
• As an "invisible wound," mild TBIs are a key health concern for the military, and can present complex and challenging problems for many service members and their families.
• The DOD's Comprehensive Strategy for Warfighter Brain Health optimizes brain health and combats TBI by addressing multiple concerns, such as potentially hazardous events that expose the brain to potential injuries, including impacts, blows, or jolts to the head that may result in long term effects of TBIs.
• TBIs can increase the risk for mental health conditions, such as anxiety and depression, as well as sleeping problems.
• Left untreated, TBIs, even mild ones, can have serious long-term complications, including visual and auditory injuries. It is critical to seek medical care as soon as possible.

TBIs affect service members both on and off the battlefield.

• Even a mild TBI can impact your readiness and ability to deploy.
• Only about 17% of TBIs occur in a deployed setting. Most TBIs occur in non-deployed settings like training, sports, recreation, car accidents, or slips and falls.
• You can limit your risk of experiencing a TBI by wearing proper safety equipment when training, deployed, or recreating.
• Service members diagnosed with TBI can often experience changes to their mental health or social interactions, which impacts their mission readiness.
• Early diagnosis and treatment, such as rest, greatly reduces the risk of having long-term effects from a TBI.
• Seeking medical attention for a TBI is a sign of strength, not weakness.

Service members can minimize the risk of TBI by learning how to prevent TBIs and understanding the signs and symptoms, and knowing when to seek care.

• A TBI is a blow or jolt to the head that disrupts the normal function of the brain.
• Not all TBIs are caused by major blows to the head -- some less obvious causes could be whiplash from car accidents, blast waves, blows to the body that jolt the head, and contact sports.
• Symptoms can range from mild to serious and can be physical, cognitive, or emotional.
• It is critical to seek medical care for TBIs as soon as possible after the injury.

TBI is treatable, and a full recovery is expected with appropriate care.

• Most people who suffer a mild TBI recover completely.
• Returning to duty following any TBI, even mild ones, should take a progressive, step-by-step approach.
• Symptoms of a TBI may reappear or worsen if activities, such as military training and sports/recreational activities, are resumed too quickly.

TBI recovery relies on an entire community of caregivers and family members who are full partners in the healing process.

• TBI can cause changes to personal and professional relationships that affect readiness. It’s imperative to seek encouragement and support.
• A critical component of TBI recovery is supporting caregivers with the information they need to support their loved ones.
• The TBI: A Guide for Caregivers of Service Members and Veterans is a recovery support tool to assist caregivers of service members and veterans who have sustained a traumatic brain injury at any severity level.

Thanks to DOD's investment in TBI research over the past decade, there have been significant discoveries made in the field.

• Discoveries include blood biomarkers, diagnostics, imaging, and graduated return to duty, among others. For example, the Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury Clinical Recommendation (PRA) is an evidence-based return to activity protocol for primary care managers and concussion/TBI clinic providers. The PRA is a six-step approach that begins after the provider performs the Military Acute Concussion Evaluation 2 (MACE 2) and diagnoses the patient with a concussion/TBI.
• We also now better understand not everyone gets better right away.
• These findings have helped make sure troops are better protected, and better educated about the risks of TBIs.
• Research findings have also helped make sure our health care providers are better educated on the diagnosis and management of TBIs.
• MHS has developed tools to quickly assess and diagnose service members with a potential TBI, including MACE 2.
• MACE 2 is a step-by-step concussion assessment tool trained medical personnel use to evaluate service members involved in a potentially concussive event at the scene of the injury.

DOD is a collaborator in the NCAA-DOD Concussion Assessment, Research and Education (CARE) Consortium/Service Academy Longitudinal mTBI Outcomes Study (SALTOS).

• More than 50,000 NCAA athletes and service academy cadets and midshipmen have enrolled in NCAA-DOD CARE Consortium studies so far, making it the largest study to date of concussion, specifically sports-related concussions.
• The CARE-SALTOS study has approximately 40% female enrollment. Previous research on concussions focused on male athletes playing contact sports, but in the military, approximately 18% of females sustain TBIs. This study will provide critical insight for that population.