Insights Into Military Traumatic Brain Injury (TBI)

 Carol L Henricks, MD

 I just returned from the 2014 International Hyperbaric Medical Conference with new and powerful insights. My thanks to Dr. Paul Harch and to physiologist Tom Fox for helping to bring to light the mechanism of injury of a TBI  as well as the proper treatment.

As a neurologist – specialist I have seen many active duty military veterans returning from deployment in my office to assess them for a diagnosis of Traumatic Brain Injury (TBI) or Post Traumatic Stress (PTS). As I go through the interview, many insist that they have not had a TBI because they have never been struck on the head or lost consciousness from a blast explosion. Unfortunately that does not mean that they have not had a TBI, and when I study them with brain MRI – DTI imaging the evidence of injury is present.

When you use a high-powered gun / weapon or are exposed to a blast (even from a distance of 150 yards or more) and you feel the impact of that blast you have a potential for injury from that event. The high power pressure wave that is created correlates to the pressure that you would feel if you were deep – sea diving. Quickly following the pressure wave there is a period of time of decreased or hypobaric pressure. This is physiologically like coming to the surface too quickly after a deep dive. So a blast exposure may create symptoms of decompression sickness. Many military veterans have been exposed to explosion after explosion after explosion, and the brain injury is cumulative. We know the treatment for decompression injury: Hyperbaric Oxygen Therapy (HBOT). This treatment was not offered on the battlefield (despite the possibility of using deployed chambers) and has not been offered as a choice for healing the chronic effects of the TBI.

Protective body armor worn by troops may multiply the brain – blast injury. Helmets protect against bullet wounds and flying debris, but they reflect the energy from the pressure wave back from inside the helmet.

Even sending injured military by life – flight may compound their injury. If you have decompression injury, one of the most harmful things you can do is to be transported in an airplane at a high altitude. Many severely injured military were transported by air to hospitals in Europe.

The more exposure you have to blasts, the closer in time those injuries are, the more injury. Many military warfighters were exposed to blast after blast after blast during the time they were deployed. IED’s. RPG’s. Repeated injury produces more disability. The injury to military veterans is similar to the injury that NFL football players suffer from repeated concussion. In fact, football players suffer repeated TBI injury from repeated impact even if they don’t clash helmets. There is more than one league of denial.

Symptoms of TBI have an extensive overlap with symptoms of PTS. If military veterans are not aware of the connection between blast injury and their symptoms, they may be falsely diagnosed with PTS or some other psychiatric condition that does not apply. It is important that all health care providers are aware of the injury associated with blast injury and ask interview questions that will bring that history to light. If we do not know the nature of the injury, we cannot treat.

Even one concussion / TBI blast injury increases the risk of suicide. The majority of warfighters have had many assaults. We cannot continue to allow our military veterans to suffer and to take their own life because we do not provide them with effective therapy. The number of military veterans that take their own life, on average, daily is 22 – 35 or more. That is 8030 – 12,775 a year and is many times more than the number of military members that were lost in combat during the recent conflicts.

The use of HBOT for TBI has been extensively documented by Dr. Paul Harch. A treatment protocol of an initial 40 treatments x 1 hour @ 1.5 ata will treat most military veterans with TBI from blast injury. As with all medical therapies, there are no absolute guarantees, more treatments may be needed, nutrition is key and adjunctive therapies may be appropriate for ultimate symptom resolution. It is a national crisis that we need to combat with urgency and effective solutions. Stop Soldier Suicide.


Carol L Henricks, MD

Behavioral Neurology, Epilepsy,Sleep Disorders, Traumatic Brain Injury  & Hyperbaric Medicine.                     .

NorthStar Neurology PC…7596 N La Cholla Blvd…Tucson AZ 85741

Office Phone: 520-229-1238

Office FAX: 520-229-1242