Changes in mild traumatic brain injury screening in the military: Will it affect civilian screening?

Brain Pet Scan

It is estimated that nearly one-quarter of deployed service members have sustained a traumatic brain injury, with mild brain injury being the most diagnosed severity. A short screening assessment that is given to service members after deployment has been used to identify the presence of mild traumatic brain injury, and has helped to identify many injured individuals. However, it has not been effective at singling out symptoms from brain injury when there is a potential for post-traumatic stress, pre-existing psychological conditions such as depression, or other co-morbid symptoms such as insomnia or pain. And this has become a challenge for military researchers and clinicians.

The challenges of screening for mild traumatic brain injury in the military are similar to the challenges found in the civilian population. Dr. Grant Iverson, a member of the Defense Health Board, recently recommended some changes to the military screening assessment. Some of his recommendations are also applicable to the civilian population.

For example, loss of consciousness is impossible to verify or quantify unless there was a witness to the event. Another screening item that asks whether an individual was "dazed or confused," is problematic because it fails to determine if the confusion came from a concussion, stress, or other physical injury.

With many millions of dollars currently being spent on military-related traumatic brain injury research, it would be wise for civilian researchers, clinicians, and other professionals to follow and adapt to any updates in military screening and diagnostic practices.

Iverson GL. Clinical and methodological challenges with assessing mild traumatic brain injury in the military. Journal of Head Trauma Rehabilitation. (April 2010).