On Screening for Traumatic Brain Injury in U.S. Soldiers

The Institute of Medicine has released several fascinating reports in the last week.  The first addressed work hours for medical residents and trainees, a subject I have addressed in the past.  The second, released today, addresses traumatic brain injury among U.S. soldiers.  The report is the latest in a series addressing the "Gulf War and Health," which included a report on Gulf War Syndrome, which I mentioned here.

In a curious parallel to some of the themes of visibility and pathology I mentioned in connection with contested illnesses, the N.Y. Times article covering the latest report (entitled "Long-Term Consequences of Traumatic Brain Injury") notes that

For years, veterans’ advocates and researchers have called for more careful investigation of head injuries — not just severe wounds but also “closed head” injuries, which do not produce visible damage and do not show up on CT scans.

Indeed, one of the most serious problems with so-called mild traumatic brain injury ("mTBI") is that the neuropathological sequelae may be protracted, that is, they may take awhile to show up.  (Full disclosure: I have a forthcoming article on concussions in professional American football, so this is an area of interest for me).  Thus a person may suffer some kind of mTBI and by all accounts appear just fine for days on end, with no visible damage.  Again, the importance of the visible in biomedical culture can, IMO, not be overestimated.

In any case, the full report is available for purchase here through IOM, and the executive summary may be downloaded for free.