Skip to main content

Military Health System

Important Notice about Pharmacy Operations

Change Healthcare Cyberattack Impact on MHS Pharmacy Operations. Read the statement to learn more. 

On National Concussion Awareness Day, Learn the Truth about TBI

Image of A mountain biker wearing a helmet bikes through hard terrain. On a monthly average, more than 1,000 service members are diagnosed with a first-time concussion. Most of them happen during recreational or routine training activities (Photo by: Senior Airman Chance Nardone, 52nd Fighter Wing Public Affairs, Mehring, RP, Germany)

Some service members might call a hard hit to the head having your bell rung, getting knocked out, or seeing stars. Your doctor calls it something else: a traumatic brain injury.

National Concussion Day is Sept. 16, bringing awareness to TBIs, signs and symptoms, the impact to the military community, and how to get help. 

A TBI is the disruption of normal brain function caused by a jolt or blow to the head, and the military population is especially susceptible. Nearly 459,000 service members worldwide were diagnosed with a first-time TBI from 2000 through the first quarter of 2022, according to the Traumatic Brain Injury Center of Excellence, which tracks multiple TBI-related data points for the Department of Defense. Concussion—also known as mild TBI—accounts for over 80% of these injuries, making it by far the most common type of active-duty TBI. 

A diagnosis of TBI requires a medical exam. With a population that has volunteered to put their lives on the line to protect and defend, it may be tempting to prioritize the mission over medicine, downplaying or ignoring any symptoms. 

Retired Marine Corps Capt. William Greeson, who was treated for brain injury at the end of a long military career, says this attitude is especially true for what he calls “military alphas.”

“[Their attitude is] ‘I’m going to go out front, I’m going to lead, I’m going to get it done, and we'll talk about this later,’” he said. “And then later never comes.”

The team at TBICoE believes that later should come sooner. In addition to researching TBI in service members and veterans, TBICoE provides training in the condition’s diagnosis, prevention, and treatment. Regional education coordinators, who are embedded in TBI rehabilitation and research facilities across the DOD and the Department of Veterans Affairs, offer educational programs for military medical providers, service members, veterans, families, and caregivers.

On National Concussion Awareness Day, there’s no better time to test your knowledge about the most common type of TBI. Can you separate fact from fiction in the following statements? 

Concussions only happen on the battlefield.

False. About 8% of active-duty concussions are from battle injuries, and only 20% happen during deployment. The rest are sustained while doing things like playing contact sports, participating in military training, or crashing a vehicle.

You don’t have to get “knocked out” to have a concussion. 

True. Concussions temporarily change how the brain works. This can be a brief loss of consciousness. More often, consciousness is altered, such as, being dazed or seeing stars, or unaffected.

You can have a concussion even without a blow to the head. 

True. A concussion may be caused by a sudden increase or decrease in speed, even if the head doesn’t strike anything. For example, the external forces present in cases of whiplash or blast injury may be strong enough to shake the brain, causing it to hit the skull and leading to potential damage. 

If you don’t have a headache, you’re fine. 

False. A headache is the most common symptom of concussion, but it’s just one of many. Concussion symptoms can be physical, cognitive, or emotional, causing a wide variety of issues such as irritability, fatigue, balance difficulties, sleep disturbance, dizziness, ringing in the ears, blurred vision, and concentration or memory difficulties. Some symptoms are warrant a trip to your local emergency department. These include:

  • Worsening headaches
  • Slurred speech or difficulty speaking
  • Unsteadiness on feet
  • Seizures
  • Double or blurred vision
  • Weakness or numbness anywhere in your body
  • Decreasing level of alertness
  • Disorientation (not knowing where you are, difficulty recognizing people or places)
  • Any unusual behavior (such as increased aggression, anger, irritability, or crying)
  • Repeated vomiting
  • Feeling that something "just isn't right" 

Symptoms of a concussion appear immediately after the injury.

 False. Concussion symptoms can start immediately after the injury—or gradually over the next 48 hours. The good news is that they often resolve within days or weeks.  

Common Symptoms of Concussion Symptoms of concussion, or mild TBI, can be cognitive, emotional, and physical. (Photo by: The Traumatic Brain Injury Center of Excellence)

You Can Recover from TBI 

Most people fully recover from a concussion, particularly if it’s their first. Service members can usually return to full duty in 2–4 weeks.

However, the time it takes to heal depends on the individual, the nature of the injury, any history of concussions or migraines, and associated conditions such post-traumatic stress disorder, depression, anxiety, and substance-use disorder. 

You should seek medical care and follow your doctor’s progressive return to activity guidance because a concussion can impact memory, concentration, coordination, reaction time, and other areas—that may affect job performance or unit readiness and safety. This is also why you must be medically cleared before picking up that basketball or your car keys. Otherwise, symptoms like dizziness, balance problems, and fatigue can put you at risk of re-injury. 

Visit TBICoE for more information about all types of TBI, as well as provider resources and support for service members, veterans, families, and caregivers. Watch real stories of recovery and hope through A Head for the Future, TBICoE’s TBI awareness initiative. 

You also may be interested in...

Publication
Feb 23, 2024

Assessment and Management of Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury

.PDF | 1.03 MB

This clinical recommendation provides medical staff with a single, comprehensive reference for the assessment and management of dizziness and visual disturbances following mild TBI/concussion. Dizziness and visual disturbances often present with overlapping symptoms and should prompt a provider to perform a visual and dizziness—or vestibular—assessment.

Publication
Feb 23, 2024

Progressive Return to Activity: Primary Care for Acute Concussion Management

.PDF | 472.50 KB

This clinical recommendation is an evidence-based return to activity protocol for primary care managers and concussion/traumatic brain injury clinic providers. The PRA is a six-step approach that begins after the provider performs the MACE 2 (Military Acute Concussion Evaluation 2) and the patient is diagnosed with a concussion, also known as a mild TBI.

Publication
Jan 31, 2024

Anomalous Health Incident Acute Assessment Training

.PDF | 1.60 MB

This virtual training, hosted by the Traumatic Brain Injury Center of Excellence, will introduce MHS health care providers to Anomalous Health Incidents and review assessment and treatment strategies. Detailed guidance on how to complete a medical evaluation using Anomalous Health Incident Acute Assessment (DHA Form 244), will be provided.

Publication
Dec 14, 2023

March 22, 2024, TBICoE QES Event: Prolonged Field Medicine and TBI

.PDF | 220.63 KB

A challenge of modern-day warfare is determining the course of care when a battlefield injury results in traumatic brain injury. Join the Traumatic Brain Injury Center of Excellence for a discussion on TBI care in austere environments.

Publication
Dec 14, 2023

2024 TBICoE Quarterly Education Series Schedule

.PDF | 209.46 KB

Save the dates with a complete 2024 schedule of the Traumatic Brain Injury Center of Excellence's Quarterly Education Series. The QES is an enterprise-wide learning opportunity for Military Health System stakeholders. Since inception, the QES provides trainings and education events that are relevant to the MHS, discussing specialty topics and current ...

Publication
Dec 4, 2023

Acute Concussion Care Pathway: MACE 2 and PRA Training Flier

.PDF | 228.63 KB

The Traumatic Brain Injury Center of Excellence is hosting a combined Military Acute Concussion Evaluation and Progressive Return to Activity clinical recommendation virtual training. Attendees may earn two CEUs through the Defense Health Agency Continuing Education Program Office. Download the flier for the complete 2024 training schedule.

Publication
Nov 29, 2023

TBICoE's Low-Level Blast Research Efforts Infographic

.PDF | 2.12 MB

This infographic illustrates TBICoE's work to better understand how low-level blast influences warfighter brain health. These efforts directly support Line of Effort 2 of the Warfighter Brain Health Initiative.

Publication
Sep 29, 2023

TBICoE Research Review: Mild TBI and PTSD

.PDF | 435.28 KB

This research review provides an in-depth summary of the available clinical research on the topic of co-morbid mild traumatic brain injury and posttraumatic stress disorder. Specifically, this review will address symptoms, anatomy, diagnosis, and treatment of mild TBI, PTSD, and the unique circumstances associated with the presentation of both.

Publication
Sep 29, 2023

Mild TBI and PTSD Clinical Pearls

.PDF | 924.82 KB

TBICoE's "Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Clinical Pearls," is a new supplemental product to the detailed research review. This resource is designed to be brief and provide key actionable “clinical pearls” that should be considered in the treatment of service members with comorbid mild TBI and PTSD.

Publication
Jun 16, 2023

Neurodegenerative Diseases and Traumatic Brain Injury Information Paper

.PDF | 310.80 KB

The long term effects of TBI are unknown, but there is concern that there may be an association with neurodegenerative diseases years after the injury. The intention of this information paper is to summarize the available evidence for or against an association of TBI with three of the more common neurodegenerative diseases.

Publication
Apr 7, 2023

2022 TBICoE Publication Catalog

.PDF | 577.80 KB

TBICoE publication citations and summaries are organized by category, or overarching research topic. The purpose of this document is to (1) summarize key findings and potential clinical implications of calendar year 2022 TBICoE publications, (2) increase awareness, and (3) assist in planning of future efforts.

Publication
Mar 17, 2023

TBICoE Research Review: Chronic Traumatic Encephalopathy

.PDF | 1.87 MB

The purpose of this Research Review is to summarize current peer-reviewed scientific literature and expert assessment regarding the pathology, genetic pre-disposition, causes, clinical manifestations, and neuroimaging of chronic traumatic encephalopathy.

Last Updated: December 01, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery