Study: PTSD, not brain injury, may cause vets' symptoms

Study: PTSD, not brain injury, may cause vets' symptoms
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Study: Symptoms usually linked to vets' concussions were actually related to PTSD

5 percent of soldiers surveyed reported battle concussions/loss of consciousness

Critic: Doctors shouldn't dismiss true brain injury symptoms as psychological only

By Yvonne Lee
CNN

NEW YORK (CNN) -- Sgt. Ryan Kahlor has the same nightmare every time, a vision of walls painted in blood and fat, and men on top of houses, throwing pieces of Marine's bodies off rooftops. It's a vision he can't shake, because he lived through it while deployed to Iraq last year.



"I have nightmares. I dwell on it. I think about it all the time," said Kahlor, 24. "Staying asleep is hard. I associate a bed with the dreams I have. My parents think I'm crazy, but I sleep better when I'm on the floor."

Kahlor has post-traumatic stress disorder, which can develop after surviving a traumatic event in which a person is physically threatened or injured.

He also experienced concussions while surviving four explosions during his 14 months in Iraq. He said these events left him with a detached retina, vertigo, memory problems and dizziness.

A new military study published Wednesday in the New England Journal of Medicine says soldiers who suffered concussions in Iraq were not only at higher risk of developing post-traumatic stress disorder and depression, but also that the depression and PTSD, not the head injuries, may be the cause of ongoing physical symptoms.

Five percent of the 2,500 soldiers surveyed by Walter Reed Army Institute of Research said they had concussions in which they lost consciousness during combat. Forty-four percent of these soldiers ended up with PTSD.

Researchers were surprised to find symptoms normally associated with concussions -- headaches, dizziness, irritability and memory problems -- were actually related to PTSD or depression.

"It isn't the combat exposure or physical injury, it's the PTSD that seems to drive these symptoms. That's a surprise," said Joseph A. Boscarino, Ph.D., who studies PTSD at the Geisinger Center for Health Research in Danville, Pennsylvania. "You would expect they would have these other symptoms related to traumatic brain injury, that maybe they have a permanent injury, but it's explained by whether they have PTSD or depression."



About 8 million American adults have PTSD. A 2003 New England Journal of Medicine Study found that 15 percent to 17 percent of Iraq and Afghanistan veterans were suffering from PTSD, and more than 60 percent of those showing symptoms were unlikely to seek help because of fears of stigmatization or loss of career advancement opportunities.

As of June 30, 2007, the Department of Defense reported 3,294 soldiers in Iraq and Afghanistan suffering from traumatic brain injuries, or TBIs. Bomb blasts caused nearly 70 percent of those TBI cases.

Dr. James Kelly, a neurology professor at the University of Colorado and a co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues.

"I think if people misunderstand or overextend beyond what this survey shows, they could dismiss true brain injury features as psychological only," Kelly said. "It would be a terrible disservice to our military for that to happen."
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http://www.cnn.com/2008/HEALTH/01/30/brain.injury/

I had TBI at the age of 4. I was pushed off a slide and hit concrete head first. My scull was cracked and I had a sever concussion. I was in the hospital for a week. It didn't cause nightmares. It didn't cause me personality to change. It did give me headaches and to this day sometimes my head feels as if it will just explode. My Mom said that my brain worked differently after. I was able to learn how to spell quickly before that and after, it wasn't so great. For a person who loves to write lacking the ability to spell correctly, it's a terrible thing. I thank God for spell check so that I stopped wearing out dictionaries.

From all indications it is two different problems they are dealing with. TBI, damage to the brain itself, shouldn't cause character changes to levels we are seeing. My husband has PTSD and was around a lot of explosions in Vietnam. From the studies I've read and living with both conditions, it is both conditions in many of these veterans and they need to look at both just as seriously and as separately as they need to be.