For veterans, minor head injuries can have lasting effects

A long-running UW Medicine study of U.S. military service members shows that many who sustained mild traumatic brain injuries (TBIs) related to combat continue to feel adverse effects for years afterward.

“What we have found, unfortunately, is that a large proportion of them have continued symptoms, and not just specific symptoms, but things that evolve over time,” said Dr. Christine Mac Donald, the study’s lead investigator. She is a professor and vice chair of research in neurological surgery at the University of Washington School of Medicine.

Mac Donald says the findings contrast much of the existing historical data on mild TBIs, which indicate that symptoms usually resolve in three to six months.

A mild TBI includes concussion caused by a bump, blow or jolt to the head. and results in the brain moving quickly back and forth. Common symptoms of a TBI are wide-ranging but can affect how a person feels, thinks, acts and sleeps. Read more about mild TBIs at the Centers for Disease Control and Prevention.

Mac Donald launched the study in 2008 while working in trauma surgery in Landstuhl, Germany. She led the effort to enroll over 500 then-active-duty U.S. service members who were based in Afghanistan or who had been evacuated to a medical center in Germany. Some had been diagnosed with a mild TBI while others had not suffered any head injury.

Enrollment continued through summer 2013 and evaluations of all participants have occurred in Seattle every one, five and 10 years since. Mac Donald says the ongoing 10-year follow-ups are delivering a surprising and concerning trend.

“At the 10-year wave, we are starting to see individuals present just generally sicker than their civilian counterparts,” she said. “They're more likely to have unhealthy conditions, or conditions of aging pop up before we typically see them: things like diabetes, heart disease, hypertension – outside of the brain.”

The well-being of veteran service members should be viewed as a major public health concern, she said.

“It doesn't matter where you fall on the political spectrum. It behooves all of us to better understand how we can help these individuals have the best quality of life as their healthcare falls to all of us – not just for themselves and for their family, but for the community that they live in, and for us as a society.”

In broadcast-ready soundbites, Mac Donald discusses the EVOLVE (Evaluation of Longitudinal outcomes in mild TBI Active-Duty Military and Veterans) study.