What We Know and Don't Know About Blast-Related TBI

I do think that we've proven without a doubt, or we've demonstrated without a doubt that the blast wave itself, which is called the primary blast wave, can injure the brain. We don't know how, and we don't know to what extent. But I think there's been a great deal of very sophisticated pre-clinical research and there's clinical evidence from some of our wounded soldiers who were involved in a blast but had no physical contact with their head to any other structure that there was a severe brain injury. For me to say much more than that I think would be so speculative. There's a school of thought that this blast wave affects the blood vessels in the brain and causes the blood vessel circuitry to go haywire and spasm such that you wind up with a pretty massive sort of bleeds within the skull and potentially within the brain tissue. But again, that has not been established with well-controlled clinical trials. There's a great, great deal of research yet to be done and I think the real challenge to the research is unless you can do open-field what we call ordinance injuries, detonations of C4 or what have you in your research population, your animal research population then the best you can hope to do is mimic the blast event with some other kind of model. So every time you do that, every time you start modeling you get usually one step further away from what happens in the real world and so you have to interpret your data that way. So it's a great challenge.

We know that blast waves alone can damage the human brain. But more research is needed to learn how exactly a blast wave alone damages the brain's cells, blood vessels, and structure as a whole.

See more videos with Dr. Frank Tortella.

Frank Tortella

Frank Tortella, ST, PhD serves as the U.S. Army’s Medical Research and Material Command’s subject matter expert on neurotrauma and neuroprotection research for a diverse range of insults to include traumatic brain injury, concussions, and the neurological effects of blast exposure.

Posted on BrainLine May 21, 2012.

Produced by Brian King and Noel Gunther, BrainLine.