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Comprehensive TBI Screening for OEF/OIF Veterans: Understanding Mild Traumatic Brain Injury

This overview highlights the structured screening process for Traumatic Brain Injury (TBI) among all OEF/OIF veterans, conducted across three VA clinic visits by various providers. It emphasizes the identification of potential concussions during deployment, with approximately 19.7% of screened individuals referred for further assessment. Mild TBI constitutes 85-90% of military-related brain injuries, with most recovering without intervention. Co-morbidity with conditions like anxiety, depression, and substance use complicates treatment. Ongoing research and interdisciplinary approaches are crucial for effective care.

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Comprehensive TBI Screening for OEF/OIF Veterans: Understanding Mild Traumatic Brain Injury

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  1. TBI Screening • All OEF/OIF patients are screened for possible TBI • Conducted within three VA clinic visits • Done by various providers • Identifies soldiers who may have sustained a concussion while deployed • Positive screens are referred for an in-depth evaluation

  2. Mild TBI • Mild TBI accounts for 85-90% of all military related brain injuries • The vast majority of people with mild TBI recover without intervention • Belanger et al., 2005; McCrea, 2008; Ivins et al., 2009 • A small percentage have persistent difficulties • Risk factors

  3. Co-Morbidity • mTBI in the military population rarely occurs in isolation • Complex web of anxiety, depression, pain, substance use • Treatment of co-occuring conditions ; utilize an interdisciplinary approach • Addressing sleep is especially important

  4. Medications • “Studies to date have yielded minimal positive evidence for enhancing function, memory and behavior after TBI.” Chew and Zafonte 2009 • Medication can be a major contributor to symptoms • DoD/VA TBI Clinical Practice Guidelines, 2009

  5. TBI and Suicide • Risk Factors • Cognitive issues • Social factors • Post injury psychiatric issues • Treatment considerations • Ongoing risk assessment • Enhance protective factors • Expectations verses capability

  6. Current Data: VA Wide • 426,413 total screened • 84,008 (19.7%) referred for further evaluation • 31,980 TBI positive (7.5% of total screened) • 12, 583 previously diagnosed • Military reports: • 428 penetrating • 271 severe • 3,389 moderate

  7. Local Statistics • Over 3000 OEF/OIF patients screened • 928 seen for secondary evaluation • 262 diagnosed with ongoing TBI related symptoms • 252 mild traumatic brain injuries • 8 moderate TBIs • 2 severe TBIs

  8. Summary • Recovery takes a lot of hard work • Research • Regeneration • Hyperbaric treatment • Altitude • Biomarkers • Imaging • Neurotrauma/blast injury

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