Care of War Veterans with Mild Traumatic Brain Injury — Flawed Perspectives

Researchers estimate that more than 300,000 U.S. veterans of the wars in Iraq and Afghanistan (20% of the 1.6 million) have sustained a mild traumatic brain injury (TBI), also known as concussion, with the majority going untreated.1 In response, the Department of Defense and the Department of Veterans Affairs (VA) have implemented new postdeployment health initiatives, including screening, communication strategies, disability regulations, and specialty care services.

Unfortunately, the clinical definition of "concussion/mild TBI" adopted by the Department of Defense and the VA — a blow or jolt to the head resulting in brief alteration in consciousness, loss of consciousness (lasting . . .

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Dr. Hoge is the director of the Division of Psychiatry and Neuroscience and Mr. Goldberg is chief of risk communication and quality assurance in the Battlemind Training Office, at the Walter Reed Army Institute of Research, Silver Spring, MD. Dr. Castro is the director of the Military Operational Medicine Research Program, U.S. Army Medical Research and Materiel Command, Fort Detrick, MD.
http://content.nejm.org/cgi/content/full/360/16/1588