Abstract

Blast tissue injury is familiar problem in military medicine for gas filled organ such as the lung and gut. Solid tissue organs such as the brain have more recently come into prominence in relation to blast through the current conflicts in Iraq and Afghanistan with blast injury regarded as the “signature injury” of these wars. Enhancements in personal protective equipment allowing survivability of abdominal and thoracic injury may have exposed a previously obscured brain vulnerability. Free field explosive detonation results in rapid conversion of chemical energy into the shock wave and pressure field, the kinetic energy associated with fragments and shrapnel, thermal energy, chemical products of detonation, and electromagnetic radiation. The variation and coupling of these physical fields result in a uniquely complex problem in understanding blast biological effects especially in such a functionally intricate organ as the brain. The clinical effects of concussion following blast exposure are still undergoing evaluation most notably in the military context. Significant effort is, however, underway to determine the relative contributions of shock wave stress, the effects of cavitation, and the effects of the electromagnetic field induced by the piezo‐electric effect of the skull experiencing blast associated stress in brain injury and recovery.

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