Bomb blasts, falls have same effect on brain - Marine Corps News | News from Afghanistan & Iraq - Marine Corps Times

Bomb blasts, falls have same effect on brain

Experts studying traumatic brain injuries have come to a surprising conclusion about head injuries from bomb blasts and from car accidents or falls: They’re basically the same.

“The brain just knows it’s bleeding,” said David Cifu, who oversees the traumatic brain injury program at the Department of Veterans Affairs Medical Center in Richmond, Va.

Because explosives are the weapon of choice for insurgents in Iraq, and because their force tosses bodies about like dolls, the services are seeing many more head injuries than in past wars.

Theories abound about blast- pressure waves causing tiny bubbles to form after passing through a brain, or compression of air in the lungs causing an injury in the brain. Some have even suggested mild traumatic brain injuries from blasts are somehow less harmful than those caused by a bump on the head.

But Cifu said current research shows that blast waves cause the same symptoms, heal over the same amount of time and should be treated the same way as any head injury.

“They look the same” as head injuries from sports or car accidents, he said. “We’re comparing apples to apples.”

If pressure waves were really passing through the skull, “you’d see lost eardrums and blown-out eyeballs,” Cifu said.

But that doesn’t mean the blasts are not causing injuries.

Ronald Glasser, who was an Army doctor in Vietnam and is author of “Wounded: Vietnam-Iraq,” said the blast from an improvised explosive device moves at 13,000 mph, gets as hot as 7,000 degrees and creates 400 tons of pressure per square inch.

“No one survives that,” Glasser said. “We’re trying to save the kids at 25 meters and beyond.”

Beyond that range, Glasser and Cifu said, injury results from the power of the blast hitting the skull like spray from a fire hose.

“The pressure is throwing their head back really fast,” Cifu said. “That rapid acceleration and deceleration appears to be causing the injury.”

The wave creates a two-strike blow: If it hits the back of the head, the brain slams the front of the skull, which then snaps back, causing the back of the brain to hit the rear of the skull.

Add to that the possibility of an overturned vehicle, flying debris and the general chaos of a roadside bomb attack, and it’s hard to tell what caused the injury, said Col. Jonathan Jaffin, head of the Army Medical Research and Materiel Command.

“In most such cases, all these things happen at once, so it’s hard to tell what the mechanism was,” he said. “But there’s no evidence that overpressure causes a brain injury.”

In April, the military rolled out a standardized treatment plan for the top 22 symptoms of traumatic brain injuries, based on years of research of civilian head injuries, Cifu said.

“The symptoms are the same,” said Barbara Sigford, director of the VA’s Physical Medicine and Rehabilitation Service. “And there’s no reason to believe [the standard treatment] is not just as effective.”