There has been significant emphasis on the topic of Traumatic Brain Injury (TBI) for returning US Service Members from the wars in Iraq and Afghanistan due to the high frequency of exposure to blast explosions. TBI has been called the “signature wound” of these conflicts and there is considerable debate on the prevalence of TBI, as well as the contribution of TBI to current symptoms that former Active Duty Service Members are experiencing after returning from deployment. TBI is graded in severity based on duration of alteration or loss of consciousness, duration of post-traumatic amnesia, and Glasgow Coma Scale score. The Veterans Affairs TBI Screening and Evaluation process was initiated to identify those individuals with possible TBI and then confirm the diagnosis by an in-person examination by a clinician with TBI expertise. The efforts of the VA to identify and care for Veterans with TBI will be discussed as well as the challenges of diagnosis and treatment of mild TBI and the frequently occurring co-morbidities of pain, PTSD, and other mental health issues. The VA/DoD Clinical Practice Guidelines for the treatment and management of mild TBI/Concussion provide recommendations for treatment and will be briefly reviewed. Veterans with a history of mild TBI and persistent symptoms are being identified by the VA which provides an additional opportunity to provide needed services for this patient cohort. This article is an overview of the lecture presented as the Special Guest Speaker at the 34th Annual Conference of the Japan Higher Order Brain Dysfunction Society.
Returning US Service Members from the wars in Iraq and Afghanistan have experienced an extremely high number of injuries, often blast-related which include Traumatic Brain Injury (TBI), Post Traumatic Stress Disorder (PTSD), and chronic pain. Additionally among these potential hundreds of thousands of Service Members with TBI, the majority experience mild Traumatic Brain Injury (mTBI) and are capable of a return to university studies and lifelong careers. The MindKnit Research Center is developing partnerships for sharing interdisciplinary research, integrated healthcare and university reintegration, models to recruit and train mentors, such as from the national Volunteer Portal under the White House with over 220,000 volunteers. Additionally, the Japan NRCD has partnered together with MindKnit Research Center and the US Veterans Health Affairs to build and sustain a vibrant “US-Japan Exchange” to share US and Japanese research, clinical, rehabilitation, reintegration and cultural models and national healthcare models to benefit both the hundreds of thousands of Service Members with TBI, but also the hundreds of thousands of persons with Brain Injury in Japan, and the 1.7 million persons with Brain Injury in the United States. Finally, this paper addresses a national Veterans Affairs healthcare study to build a nationwide model for Supported Education systems partnering the VA healthcare, university faculty and leaders, and potentially community experts such as the MindKnit Research Center and the White House Volunteer Portal-to provide successful reintegration to university for the hundreds of thousands of capable Service Member with TBI. This paper was presented as the US Co-Moderator of the Japan-US Exchange at the 34th Annual Conference of the Japan Higher Brain Disorder Society.
Providing excellent medical care and support for returning Active Duty Service Members from the conflicts in Iraq and Afghanistan remains a high priority for the Department of Defense (DoD) and the Department of Veterans Affairs (VA). Current literature reports a high frequency of multiple co-morbid conditions including traumatic brain injury (TBI), post traumatic stress disorder (PTSD), and chronic pain. Symptoms from these three conditions can become barriers to successful return to work and school. Common symptoms will be reviewed with discussion on rehabilitative efforts to overcome these barriers. Ideal management of this re-integration is best handled in an interdisciplinary manner by an experienced rehabilitation team. This article reviews the presentation “TBI and Polytrauma : Challenges Associated with Community Reintegration” presented at the 34th Annual Congress of the Japan Higher Order Brain Dysfunction Society as part of the Japan-US Exchange.