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History of military medical advancements in brain injury treatment

Army Sgt. Liliane Milo, a medic with 4th Infantry Division, checks in Soldiers for Military Acute Concussion Evaluations. Army Sgt. Liliane Milo, a medic with 4th Infantry Division, checks in Soldiers for Military Acute Concussion Evaluations. Any Soldier who has been near explosions receives this evaluation to ensure further treatment for traumatic brain injuries isn’t required. (U.S. Army photo by Sgt. Nelson Robles)

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We hear a lot about concussion in mainstream media, whether it’s a hit movie, Sunday football or even your child’s school newsletter. It hasn’t always been that way. Why do we hear so much about concussions now? Much of our new awareness stems from progress in brain injury research by military medicine. 

Traumatic brain injury (TBI) research in the military has come a long way, even before the recent conflicts, said Dr. Louis French, deputy director of operations, and a clinical psychologist, at the National Intrepid Center of Excellence. Historically, medical advances often occur in times of war or conflict, when the military finds cutting-edge ways to save lives. 

In 1901, military medical records didn’t identify TBI as a common cause of death among other illnesses such as tuberculosis, heart disease and pneumonia. Because of this, the medical community lacked understanding of brain injury. 

It wasn’t until World War I that medical professionals began seeing head injuries as an area of focus, said French. Researchers realized that service members’ intellectual abilities made a difference in how they could fight, perform their duties and contribute to the unit. 

By World War II, medical professionals started to see a rise in forms of preventive and definitive care for TBI. 

“Many forms of [definitive] care we use today, such as occupational therapy, evacuation trains, art therapy, canine therapy and sign painting were used to help patients overcome different medical issues in the past,” said French. “Some of the things we think are new, exciting interventions were rooted in previous treatment approaches.” 

The civilian sector made continuous strides in brain injury research. However, in the military there are gaps when there was little work done. For more than 50 years, from the 1920s to the 1970s, military TBI research was spotty. 

One of the early strengths of Defense and Veterans Brain Injury Center, founded in 1992, was recognizing brain injury as an emerging problem. The center re-tooled clinical guidelines to make them applicable to conflicts the military faced. During Operation Enduring Freedom DVBIC promoted awareness of service members’ struggles at home and abroad. It also shed light on how the military health system and Department of Veterans Affairs struggled to cope with the increase in TBIs. 

“Both NICoE and DVBIC made critical contributions in the field of TBI,” said French. “They have done an excellent job translating lessons to the civilian medical community and promoting working together to address these urgent health challenges.” 

One example of how DVBIC promotes continuous TBI research is its 15-year study on service members with TBI. The study focuses on service members as they move from the Defense Department to the Department of Veterans Affairs and into civilian medical care. 

“It is not enough to simply treat people. We have to think about the future impact of treatment and how it affects their lives constantly,” said French. “With all the progress we have made, there is still a long way to go.” 

French noted that brain injury treatment is still limited compared to cancer. There are 18,321 treatment plans for cancer but only 106 for concussion, 418 for posttraumatic stress disorder and 430 related to TBI. 

“We should be really proud of the momentous progress that we've made in the last 15 years in terms of caring for these service members who deserve so much from us,” said French. “We need to maintain our knowledge, readiness and need for good organizations that provide the right kind of care and the right kind of research.” 

Disclaimer: Re-published content may have been edited for length and clarity. Read original post.

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