How a Bomb Blast Injures the Brain – Understanding TBI

Kevin Kit Parker, the Thomas D. Cabot Associate Professor of Applied Science and Associate Professor of Biomedical Engineering, is researching traumatic brain injury.Photograph by Jon Chase/Harvard News Office

Former Army Maj. Kevin Kit Parker, now a professor at Harvard, has published groundbreaking research describing how blasts injure the brain.

The Harvard News writes:

Parker and his team found that when the brain is subjected to a loud, explosive force, fragile tissue slams against the skull, resulting in a surge in blood pressure that stretches blood-vessel walls beyond their normal limit.

Parker said data collected directly on the battlefield can  be key to understanding even subtle traumatic brain injury.

Seth Robbins writes about Parker’s research in a recent Stars and Stripes story that the military is using several new technologies in Afghanistan to gather battlefield data:

  • Soldiers are being outfitted with high-tech gauges that can detect a blast’s severity and alert medics on site that a soldier has been exposed to shock waves.
  • Armored vehicles are equipped with sensors that connect to each vehicle’s “black box,” which measures and stores information on blasts.
  • Two advanced magnetic resonance imaging units have been sent to Afghanistan, marking the first time such sophisticated diagnostic machines have been used in a war zone. Until now, troops couldn’t get MRI scans of their brains before arriving at Landstuhl Regional Medical Center in Germany, the main hub for servicemembers injured downrange.

A Science Magazine article gives a more detailed description of how a bomb blast injures brain cells. Parker built a blast simulator and studied the results on the brain neurons of a rat:

Through a microscope, the researchers saw that the “blast” caused swelling, breakage, and other signs of injuries to the neurons’ spindly axons and dendrites, which send and receive signals from other neurons. A series of biochemical experiments found that the mechanical force disrupted proteins called integrins that help anchor cells to the scaffold of protein that surrounds them.

You can read the full Science Magazine article HERE.

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High Tech Training to Counter IEDs – Roadside Bombs

Afghan National Army soldiers from the 205th Kandak detonate an improvised explosive device discovered on a hillside in Sangin District, Helmand Province, Afghanistan, Dec. 29. The ANA soldiers found the IED while conducting a security patrol in the area.

BY ALEX COOK and BOBBIE O’BRIEN

The military members came from 45 different countries but all with one purpose – to find better ways to find and disarm IEDs, improvised explosive devices. The roadside bombs have claimed thousands of lives military and civilian in Iraq and Afghanistan.

U.S. Central Command at Tampa’s MacDill Air Force Base hosted a conference for Counter IED Trainers this week. The focus was to teach soldiers how to think like the insurgents they will confront overseas.

Part of the training involved passing through a series of four trailers each detailing a unique aspect of IEDs like one trailer set up like a bomb makers’ shed.

The following video, shot and produced by WUSF intern Alex Cook, takes you through the four trailers for a taste of training on countering IED bomb blasts.

In the high-tech training, service members pass through a series of four trailers, each focused on a unique aspect of IEDs. They received briefings from virtual characters and participate in simulations meant to help them think like insurgents. The new training system is in use at 13 military bases around the country.

Serving on a Combat Stress Control Team

I met Cheyenne Forsythe at the Florida Ride 2 Recovery– a cycling event for wounded veterans. He was riding for soldiers with “invisible wounds,” those living with PTSD or struggling with issues like depression and substance abuse. Cheyenne is a University of South Florida student and a 6-year Army veteran who served with the 85th Medical Detachment. He was on one of the first Combat Stress Control Teams sent to Iraq’s frontlines in 2003 to help soldiers with combat stress symptoms while still “in country.” After surviving two IED attacks, Cheyenne now lives with PTSD as well.

Speaking out on veterans’ issues has become his self-ascribed mission because as he puts it: “It’s just the right thing to do.” Here are a few vignettes of what it was like for him to provide help to soldiers while in a combat zone.

Cheyenne Forsythe at the start of the 6-day Florida Ride 2 Recovery which started at Tampa's MacDill Air Force Base.

By Cheyenne Forsythe

Through creative leadership, I was able to help my Combat Stress Control Team be more effective treating soldiers in the combat zone. I made sure to volunteer for as many missions as possible so the troops around us would get to see us and respect us. Besides teaching coping skills, we went to the extreme of pulling honor guard on the body of a soldier, when the medics had been overstressed with high casualties. I made sure my team did a full 12 hour shift while waiting for mortuary affairs. 

We made sure the medics of the 126 Forward Surgical Team kept it light hearted. We were attached to that company for the first half of the tour. Their entire team was decimated by a mortar attack on movie night. The movie was “Major Payne” and that sounded awfully painful to me, so I went to the compound movie tent to watch another movie. Thirteen soldiers were evacuated home with shrapnel wounds. I usually sat in the front. The computer screen had a huge chunk of shrapnel sitting in the middle of it.

A Going Home Gesture – IED Attacks

Cheyenne Forsythe is a guest panelist for the upcoming Florida Matters show PTSD: New Hope that will air Dec. 7, 2010 at 6:30 p.m.

On my way out of country, in December 2003, we ran into two improvised explosive devices. On our way through Samarrah, to Balad, we hit the first improvised explosive device. One soldier who was a driver in a forward vehicle was killed. The next improvised explosive device went off two vehicles in front of mine, a few miles later. We stopped the convoy and formed a perimeter, stopping traffic in both directions of what would be comparable to I-75. One vehicle tried to go through our perimeter so we opened fire on it. I was the closest to the vehicle and had a good look at the occupants and called a cease fire. There were six gentlemen in the minivan. The two young adults up front were wounded, two young boys were unharmed, and two older gentlemen were also unharmed.

That’s my story of the spontaneous violence that was to be expected at any time. I counseled hundreds of other soldiers with similar stories. I even counseled soldiers who were in the same predicaments that I found myself in.

Why Some Soldiers Seek Help

As a therapist helping soldiers while still in a combat zone, Cheyenne Forsythe said it was important to go on missions with soldiers.

For example, there was the dud mortar round. On our way back to our living quarters after dinner in Tikrit, a mortar round came bouncing down the street next to me. It stopped with a thud at the back of a port-o-john where my future client was seated. He thought his buddies were playing a joke on him. I heard the whole thing on my way to my living quarters. We didn’t realize what had almost happened until a few minutes later when someone took a look at what made the thud. On the thought of his possible death the soldier tossed his dinner. He came to see me the next day. I had to repress my emotions to let him deal with his. That was the story for my whole trip. I was a tool, doing a job, keeping soldiers focused on the task at hand, despite the horrific waking nightmare all around me.

There was the couple that got hit with a mortar round while he was proposing to her on the Tikrit palace lake. They both walked into the aid station covered in blood. I counseled the female. She wasn’t sure if she should go on with the wedding.

Another soldier that stands out to me was in 1-10 Cavalry, 4th Infantry Division, the Buffalo Soldiers. He was grazed on the forehead with a small bullet and because I had volunteered to go on a mission, his buddies trusted me enough to have him get my opinion. He wanted to stay in Iraq after being wounded and wanted my opinion as to what he should do. All my hard work had paid off. Can you imagine how I felt to be included on a decision like that? I had broken down all the barriers and gotten the infantry to seek our help. 

You can hear Cheyenne Forsythe tell his story as one of the guests on WUSF’s Florida Matters program “PTSD: New Hope” which will be broadcast Dec. 7, 2010 at 6:30 p.m. 

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