Undiagnosed Traumatic Brain Injury (TBI), particularly blast-induced TBI among Iraq and Afghanistan veterans, is a severe medical condition causing immediate, long-lasting, and life-altering effects.
What is Traumatic Brain Injury?
Traumatic Brain Injury (TBI) occurs when an outside force harms the brain. It is a broad category covering everything from minor concussions to severe, permanent damage.
Historically, doctors have recognised two primary ways TBI happens:
- Blunt trauma, which occurs when the head is impacted or jolted, causing the brain to move within the skull, leading to bruising, swelling, or tearing.
- Penetrating trauma, where an object like shrapnel or a bullet pierces the skull and directly damages brain tissue.
What is blast-related TBI?
Blast-related Traumatic Brain Injury (TBI) is a type of brain damage caused by repeated exposure to the intense pressure waves generated by explosions. When a weapon or bomb detonates, it creates an “overpressure”, a wave of sudden increase in air pressure.
This overpressure is measured in pounds per square inch (PSI); for context, 1 PSI can shatter window glass, while 20 PSI can collapse a concrete building.NATO allies consider overpressure exceeding 4 PSI to be capable of causing brain damage.
Alarmingly, several weapon systems used by the British Army are believed to surpass this threshold, putting soldiers who operate them at heightened risk.
While the brain can often recover from a single mild TBI or concussion, repeated, chronic exposure to these blast forces dramatically increases the risk of serious and lasting injury.
Although there are currently no exact figures on how many veterans are affected, experts believe the problem is widespread.
What are the symptoms of TBI?
TBI symptoms can lead to:
- memory and concentration problems
- headaches
- dizziness
- visual disturbances
- sensory issues
- emotional changes such as irritability, depression, and anxiety.
Symptoms may improve over time and rehabilitation, but for those with repeated injuries, the effects can be life changing.
Why is it so hard to diagnose?
Diagnosing blast-related Traumatic Brain Injury (TBI) presents significant challenges, primarily because it is still an emerging area of study and the precise mechanisms of damage are not fully understood.
A major hurdle is the considerable overlap in symptoms with Post-Traumatic Stress Disorder (PTSD).
PTSD, a psychiatric condition common among veterans (affecting an estimated 9% of Afghanistan and Iraq veterans, rising to 17% in combat roles), shares many key indicators with TBI, such as agitation, memory problems, difficulty concentrating, and disrupted sleep.
It is not simply a matter of misdiagnosis; TBI and PTSD are often comorbid, meaning they frequently occur together in the same individual.
This makes it even more difficult for doctors to differentiate between the two conditions and ensure patients receive appropriate treatment. Adding to the complexity, the damage caused by blasts is often not visible on standard brain scans.
Unlike penetrative TBI, the injuries from blasts are widespread but microscopic, making the brain appear “normal” even when significant damage is present.
However, new technologies utilizing advanced imaging analysis are beginning to overcome this diagnostic barrier by comparing patient scans against extensive databases of healthy brains, allowing for the detection of previously undetectable abnormalities.
The Undiagnosed Trauma of War: Ian Huxley’s Story
Ian Huxley, a veteran with two tours in Iraq and Afghanistan, was diagnosed with Post-Traumatic Stress Disorder (PTSD) after exhibiting symptoms like sleep disturbances, anger issues, depression, and intrusive thoughts.
Despite conventional treatments, his condition persisted, leading to job losses, marital separation, mental health crises, and a suicide attempt. His medical records grew to over 700 pages.
Ian was introduced to the concept of blast-related mild Traumatic Brain Injury (mTBI). Although Ian never sustained visible injuries, he was frequently exposed to blasts during his service, particularly in Afghanistan.
Innovative Scan Uncovers Veteran’s Blast-Related Brain Trauma
Recognizing his own symptoms of mild Traumatic Brain Injury (mTBI), Ian Huxley volunteered for an advanced brain scan after being inspired by investigative reports on blast TBI.
Traditional scans are often insufficient for detecting the subtle, widespread damage caused by repeated explosive blasts.
To address this, Innovision IP developed an algorithm that compares MRI scans to a comprehensive database of “normal” brains, making it possible to identify previously undetectable areas of damage.
Peter Schwabach, CEO of Innovision IP, noted that many patients diagnosed with psychological conditions might actually have an “organic injury” that goes undiagnosed because the damage is not visible on standard scans.
Ian Huxley’s advanced brain scan revealed clear evidence of physical trauma. The scans showed damage to brain network connections, thinning of parts of his cortex, and the loss of vital insulation around neurons.
These findings are consistent with injury and suggest a decline in mental function.
How to treat Blast-Related TBI
Repeated exposure to blasts can lead to brain degeneration, with symptoms worsening over time rather than improving.
This can manifest as shrinkage of the brain’s outer layer, responsible for thinking, memory, and attention. Deeper within the brain, neurons, the brain’s wiring, can become stretched, torn, or lose their crucial insulating coating.
When these neurons are damaged, they can release an excess of chemicals, leading to increased stress, swelling, and further damage to surrounding brain cells.
Currently, there is no specific “cure” for blast-related TBI.
Treatment plans focus on a combination of symptom management and rehabilitation therapies.These therapies aim to encourage the brain to adapt and form new neural connections to compensate for damaged areas.
The Ministry of Defence has initiated further research to understand why some individuals are more susceptible to the effects of blast exposure than others.
Neurologist Dr. Steven Allder
Neurologist Dr. Steven Allder views cases like Ian Huxley’s as a “depressing but familiar story,” having observed similar patterns of brain damage in numerous veterans.
He emphasizes that these veterans, who served in similar environments, exhibit a “very consistent constellation of symptoms” that demands a comprehensive treatment approach, not fragmented interventions.
Dr. Allder believes this issue affects hundreds of individuals, leaving both patients and their families feeling abandoned and without answers.
Despite the Ministry of Defence funding research into blast-related TBI, campaigners assert that current scientific understanding is sufficient to warrant immediate action.
They are advocating for stronger support from the government and NHS to address this critical and frequently misdiagnosed condition affecting veterans.
Frequently asked questions
How much compensation will I get?
Compensation is awarded via the Armed Forces Compensation Scheme (AFCS). This will be a financial award calculated regarding a tariff of injuries and their severity.
There are 2 main types of AFCS awards:
- A tax-free lump sum payment for pain and suffering
- A Guaranteed Income Payment (GIP) which is a tax-free, index-linked monthly payment.
The Scheme is designed to provide compensation, irrespective of fault, across the full range of circumstances in which illness, injury or death may arise as a result of service.
Is there a time limit for making a claim?
Claims for these types of injuries or illnesses must be made within 7 years of the earliest of the following dates:
- The date of the incident leading to the injury or illness.
- The date on which an injury or illness not caused by service was made worse by service.
- In the case of illness, the date of first seeking medical advice for that illness.
- The date of discharge
However, there are certain circumstances when a claim will be accepted outside the time limits above such as being prevented from claiming due to ill health or your illness occurring later.
Further Information:
What is Traumatic Brain Injury and why is it so hard to diagnose?
‘I’ve been suffering for 10 years’: Why are brain injuries still going undiagnosed in veterans?
Oakwood Solicitors: Military Injury Claims.
WHAT TO DO NEXT:
At Oakwood Solicitors Ltd, we are committed to supporting Armed Forces personnel, veterans, and reservists, whether they are still serving or have entered civilian life. Proudly partnered with veterans’ charity, Front Foot.
If you believe you are experiencing these symptoms or are a victim of undiagnosed traumatic brain injuries caused by military work. Get in touch today for a no-obligation consultation.
Choose one of the methods on the right-hand side of this page or call us on 0113 200 9720 to find out how we can help you.
Liam Hill is a Solicitor and Deputy Head of the Industrial Disease Team, having trained and qualified at Oakwood Solicitors. Liam joined us in 2013 after successfully completing the Legal Practice C…
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