December 9th, 2008
12:00 PM ET

What's this wartime brain injury?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

Asked by Elizabeth,  Lawrence, Massachusetts

"My cousin is a marine that fought in Iraq.  Just recently, he was told he had an injury that caused his brain to actually "rattle" around in his head! What is the name of this condition and could you tell me more about it?"


 First of all, thanks to your cousin for his brave service. As someone who has reported from the frontlines in Iraq, I have witnessed, firsthand the dangers and the unimaginable sacrifices servicemen and servicewomen face on a daily basis. I’ve also met, and even operated on,  soldiers who suffer from your cousin’s condition. 

 It’s called “traumatic brain injury” or TBI. It’s a blow, jolt or penetration to the head that can disrupt the normal functioning of the brain.  It can happen anywhere and at anytime – during a fall, car crash or even rough sports. Concussions are a milder form of TBI.  

We now know, though, that traumatic brain injury has become one of the signature injuries of the wars in Iraq and Afghanistan. One of  the biggest causes are unexpected blasts from improvised explosive devices or IED’s.  Their sheer force can literally rock the brain, even when wearing a helmet.  The skull strikes a hard surface and the brain goes back and forth, like jello wiggling, and then begins to bruise from the swelling. 

It’s important to remember that there’s a broad range of severity for TBI. Common symptoms include headaches, dizziness, sleep disorders, nausea or memory problems. In mild cases, a traumatic brain injury may present as headaches or occasional dizziness. More severe cases can involve complete memory loss, personality changes or even persistent vegetative state.

Today, the Army checks soldiers before and after deployment to identify TBI cases. But unlike an obviously severed limb, traumatic brain injuries are difficult to diagnose, sometimes only noticeable years after leaving the battlefield. 

Unfortunately, there is no one way to treat TBI. Recovery depends on the severity of the case and varies from person to person. 

Everything from talk therapy to rehabilitation to the use of drugs to reduce symptoms of depression and anxiety are used.  The good news is that mild cases often require little more than rest and over-the counter pain reliever.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.