Mild Head Injuries Tied to Post Traumatic Stress Disorder

Michael Phelan

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A study published in the New England Journal of Medicine represents the military's first large-scale effort to gauge the effect of mild head injuries -concussions (many from roadside blasts)- that some experts worry may cause a host of undiagnosed neurological problems. My last blog reported on a study concluding that undiagnosed head trauma is the cause of a host of later cognitive and behavioral problems. This military study found that soldiers who had concussions were more likely than those with other injuries to report a variety of physical and mental symptoms in their first months home from active duty, including headaches, poor sleep, and balance problems. Significantly, they were also at higher risk for Post Traumatic Stress Disorder (PTSD). Symptoms of PTSD include irritability, sleep problems, and flashbacks.

This study was not designed to detect common but subtle symptoms from brain damage, such as problems with concentration and short-term memory. In its excellent series on head injury symtoms in veterans returning from Iraq, the New York Times has documented the stories of many vets still struggling with these subtle problems. Many of our nation's high school, college, and professional sports programs have implemented base-line neuropsychological testing of athletes (e.g., the Impact program) in order to better treat an athlete who suffers a concussion. It is time for the military to institute a similar program in which each soldier's cognitive functioning is tested prior to and after combat duty. Experts agree that mild brain injuries have significant pyschological component, which can improve with treatment. The problem is the injuries often go undiagnosed. Before and after cognitive function studies for athletes and soldiers is a big step toward ensuring proper diagnosis and treatment.