A case for recognizing the consequences of traumatic head injuries—and developing support systems for people who suffer
The land mine blast ripped off his helmet cover, coming at him in fiercely powerful waves. In the helicopter he awoke dizzy, gagging, and with a terrible headache. He remembered nothing. He was hospitalized for three days and returned to combat 10 days later. For a month, the headaches persisted. He then sustained three other injuries within 36 hours—he survived a mortar shelling; an anti-tank mine rolled his Humvee over; and a roadside bomb exploded under his Humvee, slamming his head against the steering wheel. His headaches became extreme and continuous. He was medically discharged.
In earlier eras, this soldier probably would have been dead, but in modern war, improvements in protective gear are saving so many lives like his. The head injuries sustained by this soldier are a common kind of residual damage. They even have a medical name, Traumatic Brain Injuries, or TBIs—which leave members of our military with debilitating migraine headaches that go on long after they return to civilian life.
This is a different kind of headache—a type that originates in nerves damaged by the twisting and shearing action of combat or by "overpressure," blast waves that come off bombs at twice the speed of sound and compress everything in their wake. The problem is surprisingly common: About one-third of returning soldiers say they have migraine pain in the first months after coming home. In 2009, there were almost 23,000 active-duty soldiers with TBI. These highly disabling migraines represent the most common reason for service women and men to seek a neurologist's care. Yet these headaches are often poorly understood by friends and family—and medical professionals often don't know how to treat them.