Care of War Veterans with Mild Traumatic Brain Injury — Flawed Perspectives

Researchers estimate that more than 300,000 U.S. veterans of the wars in Iraq and Afghanistan have sustained a mild traumatic brain injury. Dr. Charles Hoge, Herb Goldberg, and Carl Castro write that the clinical definition of “concussion/mild TBI” adopted by the Department of Defense and the VA is inadequate for achieving the objectives of their well-intentioned initiatives. Researchers estimate that more than 300,000 U.S. veterans of the wars in Iraq and Afghanistan (20% of the 1.6 million) have sustained a mild traumatic brain injury (TBI), also known as concussion, with the majority going untreated. 1 In response, the Department of Defense and the Department of Veterans Affairs (VA) have implemented new postdeployment health initiatives, including screening, communication strategies, disability regulations, and specialty care services. Unfortunately, the clinical definition of “concussion/mild TBI” adopted by the Department of Defense and the VA — a blow or jolt to the head resulting in brief alteration in consciousness, loss of consciousness (lasting . . .