Hiding in Plain Sight: Traumatic Brain Injury among Veterans

Friday, 17 July 2009: 8:30 AM

Cathy M. St. Pierre, PhD, APRN, FNP-BC, FAANP
Nursing, Edith Nourse Rogers VA Memorial Hospital, Bedford, MA

Learning Objective 1: discuss the etiology and current recommendations for assessment and treatment of Traumatic Brain Injury(TBI).

Learning Objective 2: differentiate between mild, moderate and severe TBI and its long term sequalae for veterans.

As a result of the current war, many health care providers are encountering what has become known as the “signature injury” of the war in Iraq: Traumatic Brain Injury (TBI).  It is estimated that approximately 22% of the soldiers, who have served time in Iraq, have experienced TBI. TBI isdivided into three categories: mild, moderate and severe.  Although severe traumatic brain injury is readily recognized in soldiers with “open” head wounds, TBI is not as easily detectable in those with mild or moderate traumatic injury.  Often, the veteran with mild or moderate TBI goes undetected as the veteran has experienced a closed head injury with no “outward visible signs” of trauma.  It is essential to detect and treat all three types of TBI in this vulnerable population as the long term sequelae of TBI includes: Post Traumatic Stress Disorder, Depression. Alzheimer’s disease and Parkinson’s Disease.  It is of grave concern that many veterans with TBI go undetected and in fact, have been sent back to Iraq for another tour of duty with an undiagnosed closed head injury.
    Government efforts to help identify veterans with TBI have included mandating universal TBI screening of all veterans who enter the Department of Defense or Veteran’s Administration health care systems.  Currently, there are over 23 million veterans in the United States.  However, only 20% or approx. 5 million of them seek their health care from a VA facility.  This indicates that 80% or approximately 17 million veterans are seeking care outside of the VA healthcare system and may have an undetected TBI.  The purpose of this workshop is to discuss and highlight the current evidence based strategies utilized to screen, diagnose and treat veterans with mild, moderate and severe TBI.