Understanding and treating blast traumatic brain injury in the combat theater

Abstract

Objectives: Blast injury is a frequent cause of traumatic brain injury (TBI) in the modern combat theater. We sought to explain the research and treatment associated with this injury.

Methods: We reviewed literature on the prevalence of blast TBI (bTBI), blast injury mechanisms, research, and perspectives on the neurosurgical experience treating bTBI.

Results: A majority of combat-related casualties in recent wars are due to blast. A majority of survivors of blast injuries are diagnosed with TBI. Blast injury may induce changes in the brain not seen with non-blast-related mechanisms. However, long-term symptoms are not significantly different from non-blast mechanisms. Aggressive decompressive craniectomies are commonly performed in the combat theater.

Discussion: Due to the prevalence and debilitating nature of bTBI, understanding injury mechanisms is crucial in treating the injury before symptoms become permanent. Treatment is currently limited to decompressive craniectomies, which are the most effective treatment for a relatively young and fit military population.

Keywords:

• Blast injury
• Traumatic brain injury
• GCS
• Combat neurosurgery
• Decompressive craniectomy