# Blast Effects on the Brain



## McG (5 May 2011)

The title of this article inspires one to think of Dr Obvious, but it actually has some interesting stuff once you get into it.

That blast can cause brain injuries is not a surprise, but that those injuries can occure from blast exposure we wouldn't give a second thought and that the injured can remain oblivious.  I suspect the studies that stem from this will be interesting to follow.  What is the actual threshold of injury & how is that preceived by a person?  How does this manifest itself as problems/symptoms down the road?


> *Battlefield blast waves can cause concussions
> Explosion energy hurts brain tissue, study finds*Toronto Star
> Joseph Hall
> 05 May 11
> ...


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## the 48th regulator (5 May 2011)

http://www.theglobeandmail.com/sports/hockey/concussions/SOMNIA/article2010624/


*IED shock waves found to cause concussions  * 

ANNE McILROY — SCIENCE REPORTER 
From Thursday's Globe and Mail 
Published Wednesday, May. 04, 2011 10:06PM EDT
Last updated Thursday, May. 05, 2011 8:01AM EDT

They have no visible signs of injuries, no head wounds or burns. But soldiers who are nearby when an improvised explosive device detonates may suffer mild brain damage, new research suggests.

The shock wave produced in this type of explosion can travel through the brain and cause a concussion, also known as a mild traumatic brain injury, says Andrew Baker, a researcher at St. Michael’s Hospital in Toronto.

A shock wave is a short, intense burst of energy, and Dr. Baker recently discovered that even a mild one causes damage in rats, in particular to the white matter that connects different parts of the brain and allows them to communicate with each other.

“To stand by as a blast wave goes through your brain is not a good thing,” he said.

Dr. Baker will describe the research at a news conference Thursday to celebrate the opening of the hospital’s Keenan Research Centre, which will bring together clinician-researchers from a number of fields, including neuroscience.

The findings suggest that soldiers lucky enough to escape an obvious injury after an IED blast might still be hurt. Medics who assess them need to be on the lookout for such signs as dizziness, an inability to concentrate and sensitivity to sounds or light.

You can get a concussion without losing consciousness. And if a second brain injury occurs before the first one has healed, the result can be devastating and, in rare cases, deadly.

In the rats, the damage from the mild shock wave didn’t occur instantly, but slowly, in the days that followed their exposure. This suggests it may be possible to intervene, says Dr. Baker, who published his findings earlier this spring. He and colleagues are looking at neuroprotective drugs that might limit the damage caused by this kind of injury.

Concussions usually occur when there is rapid acceleration or deceleration of the head and the brain moves or rotates inside the skull. Parts of the brain with different densities accelerate at different rates, causing damage as they move against each other. But in the case of shock waves, the injuries can occur at the junctions between different parts of the brain, Dr. Baker says.

“You could be standing perfectly still and have this burst of energy make its way through your head,” he said.

The lungs, bowel and inner ear are vulnerable to damage from shock waves, also known as blast waves. But in his research into shock waves’ effect on the brain, Dr. Baker wants to know if the damage is the same as in concussions that occur after a blow to the head or a fall.

“One of the projects we might do next is, ‘Is the physiology exactly the same?’ ” he said. “When you look at brains of people who have had repeated concussions, it is the white matter deterioration that is a problem.”

.......

Blast injuries have four parts

Shock waves, flying debris, winds and heat or chemical exposure succeed one another

When an improvised explosive device detonates, it produces a short, intense burst of energy called a shock wave or blast wave. There are four components to blast injuries.

Primary blast trauma: The shock wave causes injury to gas-filled organs like the lungs and bowels and can cause the eardrum to rupture. It may also cause brain damage.

Secondary blast trauma: These are injuries sustained when soldiers or civilians are hit with debris travelling at high speeds after the detonation.

Tertiary blast injuries: Blast winds trailing the primary shock wave can amputate limbs or throw people into the air.

Quaternary blast injuries: These result from high heat and exposure to noxious chemicals associated with the fire that follows the detonation.

Source: Andrew Baker, St. Michael’s Hospital

_© Copyright 2011 The Globe and Mail Inc. All Rights Reserved._


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## Armymedic (5 May 2011)

The article may seem to be written by "Dr Obvious", but this is what makes medicine a science. You have a theory, such as explosions cause damage to the brain similar to conclusions people sustain in sports. Now you study the theory in a manner to prove or disprove the theory. Then once it is proven/disproven, an article is published showing your study and its conclusion. This is how medical science works. If there is not a published study on a particular question, it is a theory.

And treatment practices are not based on theories.

And lets make a correction to the second article:



> Blast injuries have four parts
> 
> Shock waves, flying debris, winds and heat or chemical exposure succeed one another
> 
> ...



BTW, where I am , we are already teaching people that concussion symptoms after any blast equals a brain injury, regardless if the person is uninjured or not.


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## Bzzliteyr (6 May 2011)

So should I be getting checked out for injuries resulting from my non obvious injury producing explosion from 2007?


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## the 48th regulator (6 May 2011)

Bzzliteyr said:
			
		

> So should I be getting checked out for injuries resulting from my non obvious injury producing explosion from 2007?



Yep,

TBI/mTBI (Traumatic brain injury) is actually being studied by the CF and VAC.  Many of the symptoms are similar to PTSD, which was causing some misdiagnosis.  However, the treatment for PTSD was actually working well for MTBIs

I would still go to the MIR, or you GP and have it checked out.

dileas

tess


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## 57Chevy (6 May 2011)

Shared with provisions of The Copyright Act

IEDs can cause undetected brain injuries in soldiers: study says
http://news.nationalpost.com/2011/05/05/ieds-can-cause-brain-injuries-in-combat-soldiers-study-says/
The National Post 
Sarah-Taïssir Bencharif  May 5, 2011

Many Canadian soldiers could be coming home with brain injuries they don’t even know they have.

New research from Toronto’s St. Michael’s Hospital shows even distant exposure to shockwaves from an improvised explosive device (IED) can cause traumatic brain injuries in combat soldiers.

These short, intense bursts of energy travel as shockwaves through the brain and can cause a concussion, says Dr. Andrew Baker, the study’s senior author, speaking at St. Michael’s new Keenan Research Centre. The findings are significant, as they show concussions aren’t always caused by physical injuries. Dr. Baker says many soldiers experience explosions but don’t have the typical lung, ear, and bowel injuries caused by blasts. They say they are fine, but their brain is actually damaged.

“We found, under the microscope, broken neurons, broken axons in the white matter,” he said, adding that the damage continues to develop up to 72 hours after the blast. The brain’s white matter helps other parts of the brain communicate with one another. Damage to the white matter leads to emotional, social and behavioural problems. It causes people to feel confused, dizzy, nauseous, to have serious headaches, unable to focus and anxious.

On January 29, 2007, Master Cpl. Michael Blois was in his armoured vehicle when they were attacked by rocket-propelled grenades for four hours in Afghanistan. “I knew right away that something was wrong. I just didn’t know how serious it was,” said the 28-year-old father of one. For over a year, he continued to work as a drill sergeant back in Canada but eventually the exhaustion, nausea, dizziness and headaches limited his physical abilities. He knew it was time to get help.

“The onus is completely on the individual to do anything,” he said. “You can mask and hide your condition for a while.”

He says that though the military culture is about soldiering on, as soon as he came forward with his injury they got him help. At St. Michael’s Hospital, he continues to see Dr. Donna Ouchterlony.

“People are ignoring treatment: they’re thinking it will go away, they’re thinking there isn’t treatment,” she says. “There is good treatment available. With treatment, you can get a good life.” She says this latest research brings more attention to the development of concussions, but she knows that handling the volume of cases from the military will be tricky. More than 35,000 Canadian soldiers will have served in Afghanistan.

“We’re already seeing more [people coming to seek help]. We’re very strapped for facilities,” she continues. “I’m booking now for October, but military we see right away.”

Canada’s combat mission in Afghanistan ends this summer. Soldiers’ brain trauma may only be visible under the microscope, but it can be life changing. As the findings show, Canada will have to gear up to treat the soldiers coming back with these invisible wounds.


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## Armymedic (6 May 2011)

Bzzliteyr said:
			
		

> So should I be getting checked out for injuries resulting from my non obvious injury producing explosion from 2007?



Only if you had symptoms afterward that you did not report because you didn't know that they were related to an injury at the time.

Otherwise, it may be of no use now, unless you get concussed again.


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## Bzzliteyr (9 May 2011)

Nah, I was "up and at em" right after the incident...  Nothing health related immediately (1 month) until I left but I'm not sure they are associated.


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## TN2IC (9 May 2011)

Wondering about being 100m from an impact... IDF. Would it be my best intrest to get myself check out? No wounds or anything.. or am I over thinking this out?

Regards,
TN2IC


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## OldSolduer (9 May 2011)

Question for anyone who has insight/knowledge of TBI:

If one were a safety NCO on an 84 mm Karl G, for about 70 rds in a row, would there be an effect?


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## Bzzliteyr (9 May 2011)

Jim:  I SAID IT'S A QUARTER PAST EIGHT!!!

huh?


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## OldSolduer (9 May 2011)

Bzzliteyr said:
			
		

> Jim:  I SAID IT'S A QUARTER PAST EIGHT!!!
> 
> huh?



What you say? I went on a date??


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## Bzzliteyr (9 May 2011)

Back on topic, I remember the snipers and their 50 cals having restrictions for numbers of shots in a day due to eye damage.  I am not too sure about the Carl G.


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## OldSolduer (9 May 2011)

Bzzliteyr said:
			
		

> Back on topic, I remember the snipers and their 50 cals having restrictions for numbers of shots in a day due to eye damage.  I am not too sure about the Carl G.



I can tell you from experience as a safety NCO on the Karl is not a good thing.....


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## medicineman (9 May 2011)

Jim - I'm willing to bet if you could get a neurophysiologist to give you a hand, you could milk get a pretty good grant from the government to study that and maybe even safety staff on other ranges like live FIBUA, tank, arty...so maybe this is why I'm all bitter and twisted - was out of my hatch nurmerous times when things that go boom went boom close by.  

MM


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## OldSolduer (9 May 2011)

I can tell you the blast effect from an 84 is pretty substantial as is the blast from the 81 mm mortar on its crew . I bet there are a number of us walking around with some form of TBI. 

Where did I put my keys?


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## MJP (9 May 2011)

Jim Seggie said:
			
		

> If one were a safety NCO on an 84 mm Karl G, for about 70 rds in a row, would there be an effect?



I know I had what could have been minor concussion symptoms after roughly the same number of rounds while doing work-ups in 2005 for TF Orion.  I just never connected the two things together till you mentioned it.  I just thought it was normal aftereffect.  Funny though as we paid very carefull attention to the hearing conservation regulations but all 6 ARSOs complained of splitting headaches and general malaise the next day.


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## medicineman (9 May 2011)

I remember being on the wrong end of an 84 when it was fired and I thought someone smoked me in the head with a hammer - had to give my head a good shake (longish story)...I have few doubts that thing has to have an effect on you if you're supervisng a pile of rounds going down range.

MM


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