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