Skip to main content

Military Health System

Test of Sitewide Banner

This is a test of the sitewide banner capability. In the case of an emergency, site visitors would be able to visit the news page for addition information.

DHA Centers of Excellence collaborate to improve TBI care

Image of Medical personnel holding a model of the inner ear. Elizabeth Kirkpatrick, the physical therapist for the Fort Drum Traumatic Brain Injury Clinic at Fort Drum, New York, uses a model of the inner ear to show how a concussion can lead to dizziness and other problems. (Photo by Warren Wright Jr., Fort Drum MEDDAC.)

When a rocket-propelled grenade struck her helicopter in Afghanistan in 2011, Army Staff Sgt. Beth King sustained a traumatic brain injury and was later diagnosed with post-traumatic stress disorder. Following the event, she experienced headaches, difficulty concentrating, and problems moving around.

King’s story in the A Head for the Future video series shares how she overcame balance issues and learned to pedal a recumbent bicycle and went on to win a gold medal in cycling at the 2019 Warrior Games.

King’s story illustrates the critical role collaboration plays among the Defense Health Agency’s centers of excellence in improving recovery from a traumatic brain injury (TBI).

“Patients often have comorbid conditions such as headache, vertigo, dizziness, and visual disturbances. The joint efforts of the TBI, Psychological Health, Vision, and Hearing Centers of Excellence allow us to cover all aspects of care and management with these unique cases,” said Gary McKinney, chief of clinical practice and clinical recommendations at the Traumatic Brain Injury Center of Excellence (TBICoE) in Silver Spring, Maryland. The centers of excellence are divisions of the Defense Health Agency Research and Development Directorate.

Military soldier looking through a pair of colored glasses
A TBI patient at the Intrepid Spirit Center on Fort Bragg, North Carolina, uses colored glasses as part of vision rehabilitation, Dec. 15, 2017. (Photo by Army Sgt. Paige Behringer.)

Dizziness, for example, touches the work being done at several DHA centers of excellence, as damage to different parts of the brain or vestibular system in the inner ear can affect balance, vision and hearing.

According to one study, vestibular complaints were reported by half of TBI patients five years after injury. In 2018, TBICoE revised its clinical screening tool, now called the Military Acute Concussion Evaluation 2, to aid in assessing balance. Recently, TBICoE began revising its 2012 recommendation on dizziness, in collaboration with both the vision and hearing centers. The earlier recommendation was also a collaborative endeavor, based on the results of a 2011 conference consensus.

Vision problems related to TBI also provide opportunities to collaborate.

“It has been estimated that between 43% and 75% of people experiencing TBI events will also experience some form of vision dysfunction, which is why it is beneficial to have eye care professionals assess vision in patients who are involved in a TBI event,” said Dr. Michael Pattison, an optometrist and program manager at the Vision Center of Excellence (VCE). TBICoE participated in developing VCE’s clinical recommendations for treating vision dysfunction in TBI patients. TBICoE staff, including Division Chief Navy Capt. (Dr.) Scott Pyne, served on VCE’s working group, along with vision specialists and other subject matter experts.

TBICoE also worked closely with DHA’s Psychological Health Center of Excellence (PHCoE) to address TBI and PTSD for military health care providers. TBICoE produced a research review on these often co-occurring conditions.

Pattison also pointed out how collaboration contributed to DHA’s mission of satisfied patients and mission readiness.

“With these centers of excellence working together, we can utilize our biggest strengths, the variety of perspectives and experiences we all possess, to provide those that we are entrusted to take care of with the best possible solutions for assisting them to return to full duty and their highest quality of life,” he added. “It has to be a collaborative team approach to meet that mission.”

You also may be interested in...

Dizziness and Visual Problems After Concussion

Infographic
5/22/2023
Graphic containing general information on dizziness and vision  problems after a traumatic brain injury. Visit health.mil/TBIFactSheets and download related fact sheets for information.

More than 80% of all concussions—also known as mild traumatic brain injury—in the military are considered mild. Dizziness and visual problems are among the most common symptoms after concussion and often resolve within days or weeks

Brain Injury Awareness Month: Hearing and Vision 4

Infographic
2/7/2023
 Brain Injury Awareness: Head Injury? Seek medical help if you have these warning signs.

DYK? If you sustain a head injury, you could also have vision, balance, and hearing damage problems. See your health care provider right away. https://vce.health.mil https://hearing.health.mil #BIAMonth #TBI

Brain Injury Awareness Month: Treat

Infographic
2/7/2023
Treat: See your medical provider as soon as you experience a potentially concussive event. Learn to recognize and manage TBI symptoms.

#BeABrainWarrior – learn to recognize #TBI symptoms and don’t delay treatment. Find resources to #ProtectTreatOptimize your brain health. https://health.mil/BIAMonth #BIAMonth

Brain Injury Awareness Month: Protect

Infographic
2/7/2023
Protect: Wear a Helmet, Practice safe driving techniques and be aware of your surroundings

#BeABrainWarrior = protect your head. Learn how to #ProtectTreatOptimize your brain health. https://health.mil/BIAMonth #BIAMonth #TBI

Brain Injury Awareness Month: Hearing and Vision 3

Infographic
2/7/2023
Brain Injury Awareness: Wear Protective Gear

Vision and hearing are vital senses for effective communication and situational awareness. To defend yourself against injury and maintain mission readiness, wear the proper vision and hearing protection while on and off duty. Learn more: • Vision: https://vce.health.mil/Eye-Injury-Prevention-and-Response/Eye-Protection • Hearing: https://hearing.health.mil/Prevention/Evaluated-Hearing-Protection-Devices #BIAMonth #TBI

Brain Injury Awareness Month: Fact 1

Infographic
2/7/2023
Brain Injury Awareness Month Facts: More than 460k TBIs reported since 2000 by members of the U.S. Armed Forces

Do you or a loved one have a #TBI? You aren’t alone. Service members have reported more than 460,000 TBIs since 2000. Find tools to protect yourself from further injury, talk to your provider about your treatment, and optimize your recovery. Learn more: https://health.mil/BIAMonth. #BIAMonth #ProtectTreatOptimize #BeABrainWarrior

Brain Injury Awareness Month: Fact 2

Infographic
2/7/2023
Brain Injury Awareness Month Facts: 82.3% Categorized as Mild TBI, also known as concussion

#DYK? Most #TBI happen in garrison, not on the battlefield. Find fact sheets to help you becomes a #BeABrainWarrior and protect your head anytime, anywhere. https://health.mil/BIAMonth. #BIAMonth #ProtectTreatOptimize

Brain Injury Awareness Month: Hearing and Vision 2

Infographic
2/7/2023
Brain Injury Awareness: Heads Up

Head injuries, especially from a blast, are one of the most common combat-related injuries among deployed service members. Typical symptoms after a head injury are trouble hearing speech in noisy settings, ringing or other sounds in your ears or head, or dizziness when you move your head while walking or bending down. Talk to your provider if you have any of these symptoms. Learn more about #TBI and hearing loss: https://hearing.health.mil/Resources/Education/Conditions-and-Concerns/TBI-and-Hearing-Loss #BIAMonth

Brain Injury Awareness Month: Hearing and Vision 1

Infographic
2/7/2023
Brain Injury Awareness: Our hearing and vision providers have unique capabilities to support vision and hearing dysfunction related to TBI.

Our providers are prepared and ready to treat vision and hearing dysfunctions associated with TBI. Learn more: https://vce.health.mil/Clinicians-and-Researchers/Clinical-Practice-Recommendations, and https://hearing.health.mil/For-Providers. #BIAMonth

Brain Injury Awareness Month: Infographic

Infographic
2/7/2023
Brian Injury Awareness month infographic

Even a mild traumatic brain injury can impact mission readiness and the ability to deploy. #BeABrainWarrior by understanding the signs and symptoms of TBI and knowing when to seek care. TBI is treatable & recovery is possible. https://health.mil/BIAMonth #BIAMonth

Brain Injury Awareness Month: Main Graphic

Infographic
2/7/2023
March is Brain Injury Awareness Month. Be a Brain Warrior

Are you ready to #BeABrainWarrior? Learn how to protect, treat, and optimize brain health during Brain Injury Awareness Month. Visit https://health.mil/BIAMonth. #BIAMonth #TBI #ProtectTreatOptimize

Brain Injury Awareness Month: Optimize

Infographic
2/7/2023
Optimize. Be a Brain Warrior

#BeABrainWarrior by optimizing your #TBI recovery journey and safely return to duty. Learn how you can #ProtectTreatOptimize your brain health. https://health.mil/BIAMonth #BIAMonth

Dizziness and Visual Problems After Concussion

Infographic
1/4/2022
Graphic containing general information on dizziness and vision  problems after a traumatic brain injury. Visit health.mil/TBIFactSheets and download related fact sheets for information.

More than 80% of all concussions—also known as a mild traumatic brain injury— in the military are considered mild. Dizziness and visual problems are among the most common symptoms after concussion and often resolve within days or weeks. This infographic reviews common signs and symptoms to look out for.

Returning to Duty After Concussion

Infographic
2/24/2021
What's the best way to recover from a concussion? Returning to duty too soon after a concussion can lead to prolonged symptoms, decreased readiness, poor marksmanship, accidents and falls, and increased risk of more concussions. Progressively increasing activity in a step-wise manner can help you resolve your symptoms and return to duty safely. Ask your primary health care provider about TBICoE's Progressive Return to Activity to help you return to duty as quickly and safely as possible. Visit health.mil/TBICoE.

This TBICoE infographic gives an overview of the risks of returning to duty too soon after a concussion and explains how a progressive increase in activity can help get you back to duty safely. Returning to duty too soon after concussion can lead to prolonged symptoms, poor marksmanship, decreased readiness, accidents and falls, and increased risk of more concussions.

Sleep After Concussion

Infographic
2/18/2021
Sleep After Concussion. Service members with TBI report 3 times more sleep problems. TBIs can happen anywhere, only 16.9 percent of TBIs happen while deployed. Visit health.mil/TBIFactSheets to learn more about sleep problems and how to improve them

"Sleep After Concussion" is intended for patients and caregivers of those who have sustained a TBI. The infographic reviews general information of sleep-related concerns and points towards additional educational resources.

Page 1 of 2 , showing items 1 - 15
First < 1 2 > Last 
Refine your search
Last Updated: December 28, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery