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How Do Bombs Affect Soldiers' Brains?

"It probably would have been easier to have gotten my leg blown off"

Even though visible effects of multiple bomb blasts on soldiers may disappear, doctors and scientists are saying that there may be more lasting effects on the inside that were previously mis-diagoned as post-traumatic stress disorder.

A feature in on Nature.com, Burt -- a man who asked his real name not be used -- talks his sufferings from what he and doctors believe are the reverberating effects on his brain from bombs in Afghanistan:

The detonation of C4 and other such military-grade explosives felt like extremely high notes — painful, yet over quickly. But blasts from bombs made out of fertilizer — a favourite of Afghan insurgents — were like standing next to a speaker at a rock concert: the dull bass thuds didn't necessarily hurt, but they would reverberate through his body like a wave, and stay with him for a long time afterwards.

They're with him still. Burt [...] spent four months as a tactical adviser to a US military bomb-disposal unit in Afghanistan, during which he was within 50 metres of a detonating improvised explosive device (IED) more than 18 times. His sleeping problems began even before he left. So did the headaches, the ringing in his ears and the nausea. He started to forget things — a problem that got even worse after he returned home. Burt would find himself in a room in his house and wonder why he was there. One time, he told his wife they should try a new restaurant in town. She replied that they had eaten there with friends just a few days before.

Nature describes another soldier who went unharmed even though an IED detonated directly under his armored vehicle. Because everything seemed fine, he went back to work. But after his physical condition began to deteriorate, with some deliberation as to what his condition was, he was accepted into Walter Reed Medical Center with neurological problems.

Evidence is mounting that troops experiencing multiple blasts are suffering concussions and residual symptoms similar to Burt:

"We've got a lot of guys out there that might be 30 years old that have been blown up a dozen times," says Kevin Kit Parker, a biomedical engineer at Harvard University in Cambridge, Massachusetts, who is conducting research on [traumatic brain injury] TBI. "And the risk that these guys are going to get a disease like Alzheimer's or Parkinson's is soaring."

The number of troops affected by this kind of silent TBI has already topped 200,000, according to the Defense and Veterans Brain Injury Center in Washington DC. A survey done by the Rand Corporation, a not-for-profit research firm in Santa Monica, California, suggests it could be as high as 320,000.

This NPR video shows how one soldier has suffered from what's considered a "mild" case of TBI. He says in the video, "It probably would have been easier to have gotten my leg blown off":

This video, similarly, shows soldiers frustrated by lack of treatment for TBI:

According to Nature, TBI only recently began being recognized as a legitimate condition. In 2006, TBI research wasn't included in the fiscal year budget.  Within a year though, federal funding jumped to $150 million. In 2010, the Pentagon released guidelines for identifying and treating patients with TBI, including a requirement to screen troops within 50 meters of a blast and 24 hours of rest before being put back into duty.

Research derived from this funding has found that the blasts set off a series of cellular reactions that ends with impairment of neurological function. Other research of a deceased soldier's brain that had been exposed to multiple blasts, according to Nature, reveled damage similar to those of concussions suffered by professional athletes.

But, doctors can't cut open the brains of live patients and some traditional brain scans miss damage, making TBI hard to diagnose. Earlier this year, the Associated Press reported new software used in conduction with a typical MRI machine was revealing abnormalities in the brain that had been missed before. Other research is even evaluating soldiers' brains pre-deployment to measure differences after they return to better understand TBI.

Continuing to further recognize TBI, on June 6, 2011, Congress passed the Traumatic Brain Injury Ammendment to Department of Defense Appropriations Bill of 2012 that was initiated by Congressman Pete Sessions (R-TX-32), which allows TBI sufferers more treatment options not currently available within military and veteran medical facilities.

The Associated Press contributed to this report.

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