Traumatic Brain Injuries
Traumatic Brain Injury in Veterans
A traumatic brain injury (TBI) is defined by experts as any injury that causes a disruption in normal brain function. The effects of a TBI may be temporary or last a lifetime and can range from mild to life-altering. Individuals suffer TBIs every day through normal activities, including sports, driving a vehicle, or tripping and falling. However, military service members are, as a group, much more susceptible to TBIs, and their injuries tend to be caused from more serious sources, such as explosions, to which civilians are rarely exposed.
Statistics on Veteran TBIs
The Traumatic Brain Injury Center of Excellence has compiled data on military TBIs between the years of 2000 and 2023. They found that nearly 480,000 brain injuries were reported worldwide among US service members, and more than 185,000 veterans using the VA for healthcare were diagnosed with at least one TBI. While the majority of these TBIs were classified as “mild,” which is the classification given to the majority of TBI diagnoses, the health issues associated with these injuries are often a leading factor in the granting of disability ratings.
How Do TBIs Affect Veterans?
People who have experienced a TBI react in a wide variety of ways, depending on the nature of the injury and how it is treated. Health issues can range from mild to extreme, including:
- Headaches
- Irritability
- Sleep issues (oversleeping or insomnia)
- Memory problems (short term and long term)
- Slow recall
- Inability to problem solve
- Depression
TBIs are often diagnosed using tools such as computed tomography (CT) scan, which looks for evidence of swelling, bleeding or bruising on the brain. However, for older injuries, other tests may be more appropriate. Doctors will often attempt to collect a history of behavior issues, such as problems focusing, responsiveness to stimuli, and memory loss. They will also collect information on possible related conditions, such as changes in muscle function, vision or hearing. They may ask questions about mood and relationships to establish changes in these areas as well.
There are three main areas of dysfunction that may result from TBI and have profound effects on functioning: cognitive (which is common in varying degrees after TBI), emotional/behavioral, and physical. Each of these areas of dysfunction may require evaluation.
Classifications of TBIs
TBIs are classified by severity, although this can be misleading. The terms “mild,” “moderate,” and “severe” TBI, which may appear in medical records, refer to a classification of TBI made at, or close to, the time of injury rather than to the current level of functioning.
This classification does not affect the rating assigned by the VA since the evaluation is made based on the symptoms present at the time of the Compensation and Pension (C&P) examination.
TBIs are evaluated by VA examiners using a process that assesses ten facets of cognitive impairment which include:
- Memory, attention, concentration, executive functions
- Judgment
- Social interaction
- Orientation
- Motor activity (with intact motor and sensory system)
- Visual spatial orientation
- Subjective symptoms
- Neurobehavioral effects
- Communication
- Consciousness
Another factor that can complicate the question of the long-term effects of TBI is how many TBIs a person suffers in his or her lifetime. Recurring TBIs can have a cumulative effect, even if the individual events are classified as mild. In fact, having several concussions at different times has been associated with a greater risk of developing long-term neurodegenerative conditions such as chronic traumatic encephalopathy or CTE.
Treatment for TBI
For many veterans, the consequences of a TBI may seem to be a part of life. However, new research is showing great promise in treatments of both symptoms and root causes of TBI. In order to take advantage of these medical advances, veterans need access to the best possible treatment and services.
