Improvised Explosive Devices and Traumatic Brain Injury: The Military Experience In Iraq and Afghanistan

Abstract

Objective: The current conflicts in Iraq and Afghanistan have seen frequent use of improvised explosive devices resulting in thousands of casualties, with traumatic brain injuries particularly common. The recent literature is reviewed to provide information to clinicians on the management of this condition. Method: A Medline search from 2001–2008, using the terms Afghanistan, blast injury, improvised explosive devices, Iraq and traumatic brain injury, was performed. Results: The United States military experience predominates in the literature. The use of body armour and other advances has led to improved survival rates among blast injury victims. Resultant neuropsychiatric injuries, in particular traumatic brain injuries, are discussed. There is debate about the prevalence of traumatic brain injuries. The diagnosis, management, relationship with posttraumatic stress disorder and prognosis of traumatic brain injury are reviewed. Conclusions: Traumatic brain injury has been described as the ‘signature wound’ of the current conflicts in Iraq and Afghanistan. While this term is highly debatable and probably unhelpful, clinicians need to know about this condition to provide the best management.