Military Still Struggles to Diagnose Brain Injuries

At Iraq base, Americans were given a paper questionnaire to gauge the severity
By Bob Cronin,  Newser Staff
Posted Feb 16, 2020 10:15 AM CST
Brain Injuries Still Defy Quick, Accurate Diagnosis
US soldiers stand at the spot hit by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq, last month.   (AP Photo/Qassim Abdul-Zahra)

The official count of US service members who suffered brain injuries in an Iranian attack at a base in Iraq last month has gone up several times. Part of the reason, the New York Times reports, is that there's still no reliable way of diagnosing a brain injury. Major research efforts have made progress, but patients are still being assessed the same way. It's true outside the military, too: Patients are asked whether they're dizzy or blacked out and other questions. At the Iraq base, service members were given the same paper questionnaires to fill out that the military has used for years. "You are relying on people to report what happened," said an emergency physician in Rochester, New York. "But the part of the brain most often affected by a traumatic brain injury is memory. We get a lot of false positives and false negatives."

That makes it difficult to know whether the concussion is minor, possibly requiring a short rest, or a brain bleed that could be fatal. Patients whose brain injuries aren't diagnosed correctly and treated early are more likely to have problems later, per NPR. Saliva and blood tests are being developed that could improve the diagnosis process. They're a few years away, and their success isn't guaranteed. Even CT scans, for example, have been unable at times to spot brain injuries caused by roadside bombs, a neurosurgeon said. But a better method than a questionnaire is needed, on the battlefield and at home. "You would never diagnose a heart attack or even a broken bone that way,” the emergency physician said. "And yet we are doing it for an injury to the most complex organ in the body." (Read more brain injuries stories.)

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