Iran war renews concerns about lasting toll of traumatic brain injuries to American troops

The ongoing conflict in the Middle East, particularly the war involving Iran, is bringing renewed attention to the persistent toll of traumatic brain injuries (TBIs) on American service members. The psychological and physical after-effects of these injuries, often sustained from explosions, are raising fresh concerns about the long-term health of those deployed.

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As long as you got back up and could go back on patrol, that's kind of what you did.

Joe Shearer, a former Marine who fought in Iraq, shared his experience of being knocked down by mortar fire and later by a roadside bomb in 2005. He links both incidents to TBIs, which were only recently diagnosed. Shearer continues to suffer from symptoms including dizziness, migraines, and memory lapses, impacting his daily life and responsibilities to his family.

Public statements from military officials indicate that nearly 700 U.S. service members have been wounded by drone and missile attacks in the region. While the Pentagon's chief spokesman, Sean Parnell, characterized the majority of injuries over a recent two-week period as "minor concussions," doctors acknowledge the difficulty in predicting who will experience lasting effects. Concussions, often termed "mild TBIs," can sometimes lead to persistent problems months or years later, a phenomenon sometimes referred to as "brain fog."

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The Pentagon's chief spokesman, Sean Parnell, last month called the vast majority of injuries over a two-week period "minor concussions."

Medical experts are grappling with the unpredictable nature of TBIs. There is ongoing debate about whether to retain the term "mild TBI" given that repeated blows can increase the risk of long-term issues, including chronic traumatic encephalopathy (CTE), a degenerative brain disease linked to former athletes. Dr. David Okonkwo, a brain trauma specialist, emphasizes the importance of full recovery from a concussion before engaging in activities that carry a risk of further injury. Researchers are also still investigating how blast waves, distinct from direct physical blows, can injure the brain, with Dr. James Kelly noting that "the blast wave itself can be injurious."

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The blast wave itself can be injurious.