Frag Out! Magazine
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auditory and visual stimuli, etc.), aphasia (loss of ability to express thoughts with words and/or speech comprehension disorder) that may or may not be transient; 3 Intracranial lesion (complications related to an injury of the brain or intracranial tissues: mainly intracranial hemorrhage or hematomas); External forces may be understood as: the head being struck by an object, the head striking an object, the brain undergoing an acceleration/deceleration movement without direct external trauma to the head (the effect of the brain moving inside the skull during e.g. taking part in a car accident with fastened seatbelts), forces generated from events such as a blast or explosion, or other force yet to be defined. It's important to bear in mind that the abovementioned criteria define events that may cause TBIs. Not everybody exposed to the effects of the said forces has sustained a traumatic brain injury. But anyone who has been involved in any such event and suffers from any of the said conditions has sustained a TBI (2) (3). The severity of injury is determined usually by means of the Glasgow Coma Scale (GCS), or other scales distinguishing between various degrees of brain damage severity. The GCS is a special point- based survey used to determine the condition of the injured; the score is given for the patient's eye opening, motor, and verbal responses. The closer the score to 15, i.e. the maximum value, the better the prognosis (theoretically, at least) (4). F Three types of TBIs There are three degrees of TBI severity, and each higher degree may include conditions found in a lower degree. 1. A mild traumatic brain injury (mTBI) is also referred to as concussion. The patient is given a score of 13- 15 on the GCS scale. About 75% of all TBIs are of this type. The post-injury condition is characterized by a loss of consciousness and/or disorientation and/or loss of consciousness lasting less than 30 minutes. In most cases, the results of an MRI or a scan look normal. The injured may suffer from different cognitive disorders: problems with reasoning, concentration, memory, occurrences of mood swings, frustration, balance disorders, headaches, overall physical or mental fatigue, and instances of post-traumatic vision syndrome (PTVS) (5). 2. Moderate traumatic brain injuries (moderate TBIs) are injuries where the injured has lost their consciousness for at least 30 minutes. The occurrence of disorders listed under mTBI is much more frequent in this group. GCS score: 9–12 points. 3. Severe traumatic brain injuries (severe TBIs) are the most severe injuries, i.e. penetrating the skull and requiring neurosurgical intervention. Post-injury disorders are extensive. Cognitive and motor skills become seriously impaired. A very low GCS score: 3-8 points. The injured usually suffer till the end of their lives because of severe neurological complications. If the GCS score is below 3 points, we're dealing with vegetative state (no reaction of the injured to the external world) or brain death. Distinguishing between functional disorders is very complex and requires an individual, detailed diagnosis for each case. There's a reason behind every injury. In Europe and in the US, the biggest number of brain injuries comes from falls, traffic accidents, and from instances of being hit in the head with a hard object. In the area of armed operations, the mechanisms behind injuries are similar; what's more, they are characterized by one particular feature: they occur as a result of exposure to explosions, their shock waves, and a number of accompanying circumstances. Combat activities expose one to the risk of injuries that are very diverse in nature. If we separate the civil sphere from the environment of soldiers involved in combat, it will turn out that the injuries sustained in the present armed conflicts (Iraq, Afghanistan, Syria) are caused most often by improvised explosive devices (IEDs). Their impact on the organism appears to be more complex than the visible shrapnel wounds or burns. And IEDs have contributed to the distinguishing of a new sub-type of TBIs – the blast traumatic brain injury (blast TBI), which is a general term defining www.fragoutmag.com