Home' Army Acquisition Logistics and Technology Magazine : Army ALT April-June 2011 Contents said. Of 250,000 events recorded by the
sensors in theater, "only 60,000 of those
probably represented some sort of blast
or impact," he said. "The sensors were
actually very, very sensitive."
MRMC attempted to correlate the
sensor recordings to actual injury data
or to data found in post-deployment
health reassessments, to develop a
model of blast injury, and found that
"the sensor data correlated very, very
poorly," he said.
It will help, Gilman said, that the
Generation II sensor will allow for wire-
less download of data, versus plugging
the earlier sensor into a USB port. "I do
understand that the job of a young leader
is to go downrange and bring Soldiers
home, and it's not primarily to collect
data from helmet-mounted sensors."
TBI Research Challenges
TBI can be caused by injuries to the
head from bullet fragments and shrap-
nel, blunt impact injuries such as from
a collision, or blast events such as the
detonation of an IED. Blast, ballistic,
and blunt impacts are separate phe-
nomena, with different characteristics.
The least understood are blast injuries.
What is known is that blast injuries can
result in long-lasting neurologic and
psychological problems. Body armor
allows the lungs to tolerate blast effects,
but the brain is exposed to blast levels
in ways that medical experts are still
trying to measure.
Experts from the military medical
community agree that correctly under-
standing the biomechanics of blast
injuries is vital to the Army's opera-
tions, readiness, and health.
"The term itself causes a lot of confu-
sion. ... It's a very, very broad spectrum
of injury types," said Michael J.
Leggieri Jr., Director of DOD's Blast
Injury Research Program Coordinating
Office within MRMC.
"We have a vast medical TBI research
portfolio ... focused on knowledge
gaps," Leggieri said at the Head
Protection Summit: "How do we
prevent injury? How do we quickly
diagnose that injury? How do we
reset? How do we return that person
[to active duty]?
"There's a lot we don't know about this
injury," he said, although "there are
many, many hypotheses about how this
injury occurs. If we don't understand
the mechanism, there's no way we can
develop effective protection strategies."
Continuum of Research
The diverse body of TBI and PTSD
research can be organized, as MRMC
has done, along a continuum of care for
the Soldier or patient, from prevention
through assessment and finally, return
to duty or long-term care.
TBI in particular "is still a very unique
problem in our estimation, because we
still don't have a full, clinically well-
accepted diagnosis," said Gilman at
the Army Science Conference. Instead,
a diagnosis of TBI "is based on the
subjective report of an exposure to an
event, and some reported or estimated
proximity thereto, and then some symp-
tom that occurs soon, or immediately
after that event. And that symptom can
be nothing more than disorientation.
So right now we are still struggling
to find the gold standard, and this is
impacting every one of our efforts in
terms of traumatic brain injury."
Following the continuum (see chart
below), these efforts include:
• Prevention and Protection---At least
three pharmaceutical or nutraceuti-
cal products, including the omega-3
fatty acid docosahexaenoic acid
(DHA), hold promise for protecting
the brain from injury. "If effective,
then we can supplement rations with
[DHA] and perhaps mitigate or ame-
liorate the consequences of exposure
to blast," said Gilman.
• Early detection---Ultimately, the
helmet-mounted sensor may be able
to provide this capability, which
could improve the outcome of a
Soldier's exposure to blast.
• Screening---Deficits in visual
tracking performance are one
manifestation of diffuse axonal
MG James K. Gilman / MCMR-ZA (301-619-7613) (DSN 343-) / James.Gilman@us.army.mil
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30 Nov 2010
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DETERMINES RESEARCH APPROACH
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