Iraq Brain Injury Study: More Evidence On Process of Brain Injury

By Attorney Gordon Johnson

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One of the absolute cornerstone’s to my belief system as a brain injury advocate, is that brain damage is not an immediate occurrence but part of a complex and multi-factorial process that occurs not just over minutes, but as much as 24-72 hours after the trauma. This is an issue I can almost always get defense experts to admit, but not always within the type of trauma I represent people, concussions from fall and car wrecks. Last week I was blogging on the good and the bad of the huge influx of new brain injury research coming out of Iraq, but today’s new release is clearly all positive.

In research summarized at http://www.jhu.edu/~jhumag/0208web/wholly.html#apl researchers at Johns Hopkins are saying that “Blast exposure, especially repeated exposure, can cause brain damage so subtle that soldiers may not realize they’ve been wounded. Ibolja Cernak, director of the Biomedicine Business Area at the Applied Physics Laboratory, says that these mild brain injuries can lead to gradual neurodegeneration, similar to Alzheimer’s disease.

The main researcher on this work is Ibolja Cernak, director of the Biomedicine Business Area at the Applied Physics Laboratory, at Johns Hopkins.

While there has been little controversy that blasts can cause brain damage, even without a direct blow to the head, presumably from the rapid jostling of the brain matter, inside of the skull. The Johns Hopkins story explains:

“The prevailing argument has been that waves of compressed air emanating from the blast shake the skull with enough force to strain or stretch the brain, not unlike what happens in a bad car crash. ‘It’s like a turbo-charged whiplash,” says Ross Bullock, a professor in the Department of Neurological Surgery at the University of Miami.”

But Cernak’s research posits that the blast energy is transferred in waves to the large blood vessels, which bring blood to the brain. She claims that the drastic pressure changes and rushes of blood thru these vessels from the blast, then damage the small vessels within the brain and the adjacent tissue. While not clearly more complex, analogize this to getting a bloody nose, following a series of violent sneezes.

There clearly is historical evidence to support this as an additive theory as to how the brain gets injured in combat. One of the frustrating things about modern brain injury research, is that it is done with so little historical perspective on what was known about brain damage from what I would call the “collective common sense” of centuries of working with people who were “quite right in the head” after combat. The whole concept of shell shock evolved not just because soldiers were injured by the enemies shells, but also were exposed to brain damage, from being on the sending end of shelling. Sailors on British ships of the line, were known to be at risk of getting funny, if allowed to work below deck for too long.