How Does the Military Define and Identify a Concussion?
The definition is the same as in the civilian world, but different precautions are taken before a soldier is released back to combat.
The military defines concussion in a way that's very consistent with the civilian definitions, and it is a change in neurological function, especially an alteration in mental function-- mental status--as a result of a biomechanical blow to the body, not necessarily even the head. The head, obviously if it is struck, would be one of the definition parts as in the civilian literature, but it also can occur with a whiplash mechanism injury, and that's known in the civilian world as well. So it was intentionally consistent with the Centers for Disease Control, the American Academy of Neurology, the American Congress of Rehab Medicine, and other definitions that have been merged; and some of the very people that wrote those other definitions were in the room when the military defined mild TBI. The latest effort in theater--in war zones--is for any individual who may have had a concussion because of a blast, car crash, or some event to actually be assessed by health care providers to determine whether they had a concussion. And the definition that we talked about before of concussion really requires a history from that individual. What happened to you? What happened to your brain at the time? What do you remember? It's not a scoring on a mental status test. It's literally a history of what happened minutes, or hours, or days, or weeks previously; and so learning from that individual and eyewitnesses--bystanders-- that's how the diagnosis is made. Then you determine whether it's worrisome or not by doing the testing, and that's what the health care providers are actually now applying and tracking over 24 hours. Any of those individuals who are now required not to go back to duty if such an event occurred-- so they all go through the screening, and then they all wait 24 hours to see if anything else develops in terms of symptoms or mental alterations before they're released to go back.
Posted on BrainLine October 20, 2010.
Produced by Noel Gunther and Brian King, BrainLine.