Military Blast-Related Traumatic Brain Injury

Abstract

This paper aims to review and discuss the epidemiological, neuropathologic, and mechanistic characteristics of blast traumatic brain injury (bTBI) specific to the military population. Military service members have sustained over 383,000 reported incidents of TBI since 2000. In combat, mild bTBI due to explosive attacks comprise the most common type. Identification, treatment, and reporting of bTBI are compounded by the operational demands of combat as well as frequent co-presentation with PTSD and associated injuries. Following primary injury, a secondary metabolic and inflammatory cascade in bTBI leads to an array of symptoms and impairments. Development of screening batteries, sensors, and laboratory assays has sought to advance evaluation and management. bTBI is a widespread, though underreported, injury in service members with significant neurological and cognitive impacts. The highly prevalent traumatic and psychiatric comorbidities incurred in combat must be considered in the approach to management. Further research is needed to improve bTBI detection and facilitate prognosis.