Concussions are the most frequent battle injury sustained in Afghanistan. The Concussion Restoration Care Center provides multidisciplinary care to concussed service members in theater. The Concussion Restoration Care Center has managed over 500 concussions, the majority being from improvised explosive device (IED) blasts. Syncope following a concussion without a loss of consciousness is rarely...

Little is known about the effects of blast exposure on the human brain in the absence of head impact. Clinical reports, experimental animal studies, and computational modeling of blast exposure have suggested effects on the cerebellum and brainstem. In US military personnel with isolated, primary blast-related 'mild' traumatic brain injury and no other known insult, we found diffusion tensor MR...

IMPORTANCE Blast injury has been identified as the signature injury in the conflicts in Iraq and Afghanistan. However it remains to be determined whether fundamental differences may exist between blast-related traumatic brain injury (TBI) and TBI due to other mechanisms. OBJECTIVES To determine similarities and differences between clinical outcomes in US military personnel with blast-related ...

Death and injury due to terrorist bombings continue to exercise civilian and military surgeons alike. In this paper 828 servicemen killed and injured by explosions in Northern Ireland have been studied, using data stored in the Hostile Action Casualty System (HACS). Because of the nature of the conflict in Northern Ireland, the magnitude of each explosion and the distance of the victims from it...

OBJECTIVE Bombing is the primary weapon of global terrorism, and it results in a complicated, multidimensional injury pattern. It induces bodily injuries through the well-documented primary, secondary, tertiary, and quaternary mechanisms of blast. Their effects dictate special medical concern and timely implementation of diagnostic and management strategies. Our objective is to report on clinic...

BACKGROUND Esophageal perforation after external air-blast trauma is rarely presented in the emergency room. The diagnosis is often delayed more than 24 hours. METHODS We review the literature and report a case of esophageal perforation caused by external air-blast injury. RESULTS Including the present case, a total of 5 cases of esophageal perforation were caused by external air-blast inju...

Blast-induced traumatic brain injury (TBI) has become a major issue as a consequence of deployment of military personnel under the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) in Iraq and Afghanistan, respectively. Threats during missions of the (Dutch) troops in these recent operations are not comparable with threats experienced formerly. They now have to deal with Improv...

BACKGROUND Blast-induced neurotrauma (BINT) is the signature life threatening injury of current military casualties. Neuroinflammation is a key pathological occurrence of secondary injury contributing to brain damage after blast injury. We have recently demonstrated that blast-triggered complement activation and cytokine release are associated with BINT. Here, we evaluated if administration of ...

The Department of Defense Hearing Conservation Program provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of dem...

STUDY DESIGN A retrospective case series of UK victims of blast injury. OBJECTIVE To identify the injury patterns in the spine caused by under-vehicle blast, and attempt to derive the mechanism of those injuries. SUMMARY OF BACKGROUND DATA The Improvised Explosive Device has been a feature of recent conflicts with frequent attacks on vehicles, leading to devastating injuries. Vehicle design...