New Developments Lead to Early TBI Detection

By Navy Petty Officer 1st Class Molly A. Burgess
Emerging Media, Defense Media Activity

April 2, 2010 - Advanced brain scans that can detect injury earlier than before are among several improvements developed by military doctors and scientists to treat servicemembers with traumatic brain injuries.

Researchers at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury have focused on early detection and better monitoring of mild traumatic brain injuries, or concussions, which account for most TBI diagnoses.

Several scanning techniques, including diffusion tensor imaging, single photon emission computed tomography and functional magnetic-resonance imaging, look especially promising.

"They are showing changes in concussion that will help delineate the area of injury," Kathy Helmick, director of the TBI Clinical Standards of Care Directorate at DCoE said during a Dot Mil Docs interview, adding that the scans also help map treatment plans.

In addition, DCoE has partnered with the Department of Veterans Affairs to develop clinical guidelines and support tools that work in any environment. These tools include handy pocket cards that can speed detection and early treatment.

DCoE also has changed its recommendations so that some events now prompt testing for TBI even when there are no symptoms of brain injury.

"We have changed from a symptom-based approach such as having a headache, to an incident-based approach," Helmick said. "If you have an injury event that could cause a concussion, it becomes mandatory to get a medical evaluation." Early detection and treatment are the cornerstones to positive outcomes, she added.

To ensure that all brain injuries get diagnosed, DCoE has added multiple screenings during and after deployments.

Since a diagnosis of brain injury takes a toll on patients and families, support programs are being expanded. A congressionally mandated guide to help caregivers is being published next month, which Helmick said will help families "navigate the journey" following moderate-to-severe brain injuries.

TBI clinics in military facilities are increasing the number of staff and case managers who coordinate care with servicemembers and their families, she added. Local support efforts include Web-based training as well as the DCoE Outreach Center, a 24/7 call center staffed by health resource consultants to provide confidential answers, tools, tips and resources about psychological health and traumatic brain injury.

Advanced treatments for brain injuries will only be effective if servicemembers know where to go to seek tests and clinicians are on alert to recognize the signs of TBI, Helmick said.

(Petty Officer 1st Class Molly A. Burgess works in the Defense Media Activity's emerging media directorate.)