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TBIs: Still a Vastly Misunderstood Field

Thursday, February 20, 2020

In the past two decades, a growing prevalence of Traumatic Brain Injuries has established TBIs as the “signature wound” of the post-9/11 war. Upwards of 410,000 service members have been diagnosed with a TBI since 2000, according to the Defense and Veterans Brain Injury Center. Yet, even with this remarkable number of instances in which TBIs have been diagnosed, doctors are still working out one concrete way to diagnose and treat this illness.

The issue largely lies in the field of testing for TBIs. One of the biggest problems in diagnosing TBIs is ensuring that tests are sensitive enough to show even the mildest forms and determining who needs a longer recovery. Across the board, physicians have yet to agree on the amount of activity a patient should be engaging in after a TBI.

Diagnosis and treatment of TBIs is incredibly important as in the long term, patients can experience gaps in memory, depression, anxiety, and trouble sleeping, and several other issues. In order to ensure the highest chances that these significant health issues are not results of a patient’s TBI, the approach to diagnosis and treatment must be critical and thorough.

In regard to TBI treatment, many doctors still have opposing opinions on what should be done in the days following a TBI. Ghajar, the director of Stanford University’s Brain Performance Center, says that a lot of physicians say, “well, you shouldn’t do anything. Go into a dark room, don’t strain the brain and wait until you recover.” As a result of this approach Ghajar says there is a national epidemic of patients “sitting in a room waiting for their headache to go away.”

Ghajar states that he and other researches have “published literature that found that early exercise after a concussion speeds recovery.” He goes further to say that isolating people can cause a delay in recovery. Ghajar’s approach relies on therapy specifically designed for the patient’s symptoms.

For Dr. David Cifu, a Virginial Commonwealth University health professor researching TBI for the government, the approach lies in helping the whole person. If a patient is suffering from anxiety, Cifu said he might refer them to a psychologist in addition to the therapy Ghajar mentioned.

Treatments vary across the board for TBIs and Military care providers are eager to find one objective test that will help diagnosis. The current best practice is simply talking to the patient. This remains to be a very difficult approach as any two people are likely to describe the same symptom differently. The VA researchers continue to explore the field in search for the best methods in dealing with TBIs. While TBIs, unlike the loss of limb, are not as apparent to the public, they can have serious and deadly symptoms over time. Consequently, research in this field is of great significance and cannot be overlooked.

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