Medical Monday: “Hot Topics” in the Treatment of TBI

Brain Injury Awareness Month gives us an opportunity to raise awareness and support for service members, veterans and families whose lives are affected by traumatic brain injury (TBI). As DCoE’s deputy director for TBI, I work with many others including the Defense and Veterans Brain Injury Center to improve TBI care delivered to service members in deployed and non-deployed environments. The Defense Department made significant advancements in TBI management during the past several years and we’re continuing to learn as we treat. Navigating the clinical challenges that providers face in the field is critical to ensure we’re employing state-of-the-art care for all levels of TBI severity, from concussion to severe and penetrating brain injuries.
The department is aggressively working to improve the diagnosis and treatment of TBI in-theater. By issuing the Directive Type Memorandum (DTM) “Policy Guidance for Management of Concussion/Mild TBI in the Deployed Setting,” commanders or their representatives are required to assess all service members involved in potentially concussive events, to include those without apparent injuries, using the Injury/Evaluation/Distance from Blast (I.E.D.) checklist.

By Kathy Helmick

For brain injuries, a treatment gap

The first two doctors who examined Scott Hamilton 's fractured skull told his wife that he wouldn't make it through the night. A third believed he could save Hamilton's life.

On Oct. 26, 2005, Hamilton was tossed from his Vespa motor scooter on Market Street in San Francisco during his 2-mile ride to work. He was going 25 mph when his tire skidded on a trolley track, and his helmeted head struck the pavement.

Geoffrey Manley, director of brain trauma at the University of California-San Francisco, said keeping Hamilton alive would be just the start of the road to recovery. To increase his chances of returning to a normal life, Hamilton would need the type of intensive rehabilitation care now being provided to Rep. Gabrielle Giffords, who was shot in the head in Tucson on Jan. 8.

By Steve Sternberg, USA TODAY