Chronic traumatic encephalopathy (CTE) is a neurodegenerative syndrome that can develop from repeated impacts to the brain. CTE has been studied in sports such as football and boxing, where athletes develop a long-term pattern of symptoms that are not unlike those of Alzheimer’s syndrome.

Post-traumatic stress disorder (PTSD) has become a common diagnosis in our returning soldiers, but a recent case study suggests that the PTSD may actually be a type of CTE that develops after repeat exposures to blast explosions. In this case study, a soldier who was diagnosed with PTSD committed suicide not long after an honorable discharge. The autopsy of his brain found damage that was surprisingly indicative of CTE.

This case study is important because it may help re-direct the diagnostic guidelines for returning soldiers. It may also help researchers understand the pathology of repeated exposure to blast explosions, as well as the pathology and long-term effects of CTE.

Omalu B, Hammers JL, Bailes J, et al. Chronic traumatic encephalopathy in an Iraqi war veteran with post traumatic stress disorder who committed suicide. Neurosurgical Focus. (November 2011).

Post-traumatic stress disorder (PTSD) can occur after experiencing a traumatic event and may lead to poor recovery and psychological difficulties. Studies over the past few years have shown that admission to an intensive care unit (ICU) is associated with the development of PTSD.

There are several established reasons why PTSD might be associated with admittance to ICU. For instance, life-threatening injuries and the psychological trauma associated with witnessing a traumatic event can increase the risk of developing PTSD. Additionally, people with a psychiatric history are more likely to be admitted to ICU for a traumatic injury than the general population.

An Australian team of researchers recently conducted a study to determine if admittance to ICU itself increased the risk of developing PTSD, and to uncover any other factors that might increase that risk even further. They found that, independent from any other risk factor, people admitted to ICU were three times as likely to develop PTSD. Other factors that increased this risk were:

1. The presence of a mild traumatic brain injury
2. Female gender
3. History of trauma or psychiatric disorder
4. Longer length of hospital admission

The research team cited 3 possible reasons that ICU admission could increase the risk of PTSD. Sleep disturbance, increased stress, and delirium from certain drugs could all play a role in how the brain processes traumatic events. Screening tools to identify high-risk patients and low doses of sleep agents may be effective interventions.

O’Donnell ML, Creamer M, Holmes ACN, et al. Posttraumatic stress disorder after injury: Does admission to intensive care unit increase risk? Journal of Trauma Injury, Infection, and Critical Care. (February 2010).

On Thursday, November 19, 2009, The Senate voted to pass a package of veteran’s bills (S1963) that included both S. 801 and S. 252, both important Veteran’s health care measures supported by BIAA.

The bill would expand services in rural areas and ensure that veterans who are catastrophically disabled or who need emergency care in the community are not charged for those services. It would also authorize VA hospitals to contract with non-VA providers to ensure that our returning service members have access to the care that they so desperately need and deserve.

Thank you to all of our grassroots advocates that responded to the two action alerts that helped to move this measure successfully through the Senate!

On Tuesday, March 3, 2009, the House Appropriations Subcommittee on Defense held a hearing to address the need to improve the quality of care for servicemembers suffering from traumatic brain injury.

The witness list included, Ellen Embry, the Deputy Assistant Secretary of Defense for Force Health Protection and Gen. Loree Sutton, the Special Assistant to the Assistant Secretary of Defense for Psychological Health and Traumatic Brain Injury.

General Sutton shared with the Committee that the Defense Centers of Excellence is committed to research that is aimed at understanding the differences between blast injuries that would occur on the battlefield and concussions that may be experienced on a football field or during civilian activities. The spectrum of ingredients that include life-threatening situations, psychological stressors, and moral conflicts are all factors that contribute to the unique nature of brain injury incurred through battle.

On Thursday, President Barack Obama held a White House summit on health care reform. At the summit, President Obama made his intentions clear that an overhaul of the nation’s healthcare system should be completed by the end of this year. The President addressed a room full of lawmakers, healthcare providers, labor unions, and journalists calling healthcare reform a “fiscal imperative” vital to restoring the nation’s economic status.

In his opening address, the President detailed that the purpose of the summit was to determine how to improve quality of care and access to care in an inclusive and transparent manner. He specifically noted that American small businesses are struggling to insure their employees and large corporations are battling to compete with overseas entities. He also expressed the fact that Medicare costs are a substantial burden on the federal budget and Medicaid expenses are consuming much of the states’ budgets.

The President addressed the need for an investment in reform that will lower costs, create jobs, and help to erase our nation’s deficit in the long term.

Peter Thomas of Powers, Pyles, Sutter and Verville PC attended the White House summit as a representative of the Consortium for Citizens with Disability’s (CCD) Health Task Force, of which BIAA is a member.

Multiple BIAA representatives attended this week a scientific conference titled, “Trauma Spectrum Disorders: The Role of Gender, Race & Other Socioeconomic Factors.” This conference – jointly sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, the Department of Veterans Affairs, and the National Institutes of Health – focused on identifying and sharing knowledge and lessons learned about gender and race as they relate to psychological health and traumatic brain injury.

Presentations made at this conference are expected to soon be made publicly available on the Defense Center of Excellence’s website: http://www.dcoe.health.mil/.