ABSTRACT
Traumatic brain injury—an injury to the brain that may or may not create lasting impairment for the survivor—has been recognized as a major public health problem by the Centers for Disease Control (Langlois, Rutland-Brown, & Thomas, 2006). Ongoing conflicts in Iraq and Afghanistan have highlighted the problem for the military (Warden, 2006). Along with post-traumatic stress disorder, traumatic brain injury (TBI) has become known as one of the “signature wounds” of the current conflicts—Operation Enduring Freedom and Operation Iraqi Freedom (Altmire, 2007). Modern warfare in Iraq and Afghanistan includes the widespread use of Improvised Explosive Devices (IED). Detonation of IEDs exposes service members to multiple risks for traumatic brain injury including injury from projectile material, or shrapnel, as well as from the primary blast wave itself. It is estimated that at least 30 percent of troops engaged in active combat in Afghanistan/Iraq for four months or more had suffered a mild TBI as a result of IED blast waves (Hoge, McGurk, Thomas, et al., 2008). While the majority of traumatic brain injuries that occur are classified as mild and have excellent prognosis overall (Iverson, 2005), both for civilians and the military, persistent problems do occur in some individuals.
