invisible wounds
By Jennifer Fisher Wilson
Repeat Concussions Can Sideline Soldiers
When the risks are this high, prevention and recovery are of utmost importance.
IN THE MILITARY, a concussion can temporarily keep a soldier out of a war zone. When that concussion is followed by another concussion, the effects can be devastating.
Concussion is one of the most common injuries impacting today’ s military. Among servicemen and women with exposure to combat in Iraq and Afghanistan, 15 to 20 percent experience traumatic brain injury; of those, 85 percent are mild concussions, the result of exposure to blasts. 1
Although likely underreported, repeat concussion( or“ cumulative concussion”) seems to occur among a smaller segment of the military population. One study found 113 reports of repeat concussion among 14,653 servicemen and women who served in Operation Iraqi Freedom from 2004 to 2008. Among those, 20 percent suffered the second trauma within two weeks of the first; another 87 percent experienced the second trauma within three months of the first concussion. 2
“ We are seeing more of this in the military because the head becomes more vulnerable with the type of combat occurring in the world today,” says Roger Cady, MD, associate executive chairman of the National Headache Foundation and founder and director of the Headache Care Center, Inc. in Springfield, Mo.
Despite the smaller population, the risks are more significant for individuals who suffer repeat concussions than for those who suffer a singular concussion. Research indicates that recovery is slower, neurological damage is prolonged and susceptibility to additional brain injuries increases after repeat concussions. 3 To avoid complications, military servicemen and women must make every effort to avoid concussions and take time to heal after trauma occurs.
FROM CONCUSSION TO CHRONIC HEADACHE
A single concussion can trigger post-concussion headache in the form of tension-type headache, episodic migraine, chronic daily headache or a combination. Those who already had headaches or a family history of headaches prior to trauma are more likely to experience some form of post-concussion headache.
For soldiers who already experience headache, repeat concussions can take an episodic condition and turn it into a chronic, daily problem, says Alan G. Finkel, MD, FAAN, FAHS, a contractor for the Henry Jackson Foundation / Defense and Veterans Brain Injury Center at Fort Bragg, N. C. and co-founder of
1. Rigg and Mooney.“ Concussions and the Military: Issues Specific to Service Members.” PM & R. 2011; 3: S380-S386. 2. MacGregor et al.“ Repeated Concussion Among U. S. Military Personnel During Operation Iraqi Freedom.”
Journal of Rehabilitation Research & Development. 2011; 48( 10): 1269-1277. 3. Defense and Veterans Brain Injury Center.“ Cumulative Concussions.” www. dvbic. org / cumulative-concussions
14 HEAD WISE | Volume 2, Issue 4 • 2012