In 2000, there were 10,963 servicemembers diagnosed with traumatic brain injury, or TBI. By 2009, the number had skyrocketed to 27,862.

Due to the dramatic increase in TBI diagnoses, the Department of Defense is increasing efforts to educate soldiers about TBI, implementing new policies for early detection, and funding research studies for use of certain medications.

"Most soldiers will recover from a mild traumatic brain injury with time alone," said Dr. Frederick G. Flynn, the medical director of Madigan Army Medical Center's Traumatic Brain Injury Program.  "But for the most part, the number one treatment overall for mild traumatic brain injury is early education." 

With that in mind, the MAMC program provides servicemembers, spouses, commanders, and providers several education opportunities.  These include:

• Custom briefings on TBI

• Flyers and brochures

• Education sessions for soldiers who are re-deploying  

• 90-minute pre-deployment training sessions for medics, physician assistants, and other medical personnel

• A 20-minute program for company commanders and first sergeants

• Professional development opportunities for providers

"The main thing that we want to get through to all of these servicemembers who deploy is that if they are nearby a bomb blast or IED explosion, they need to get checked out for their own protection," said Bronwyn Pughe, the TBI education specialist administrator for the MAMC TBI program.

The educational briefings explain what a TBI is and is not. In October 2007, the Defense Department established a formal definition of TBI as a "traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force."

The troops also are educated about the symptoms of a mild TBI. Symptoms are broken down into three categories: physical, which may include headaches, dizziness and balance problems; cognitive, which may include memory loss and concentration problems; and neuro-psychiatric, which may include acute and chronic stress, anxiety or depression or heightened impulsivity, and feelings of having a short fuse.

Education of the troops will play a major role in decreasing the persistent effects of mild TBI on soldiers. Last year, about 7,500 TBI patients were seen by medical specialists who work with MAMC's TBI Program, Flynn said. A majority of these servicemembers returned with their units after sustaining a mild TBI with undiagnosed symptoms.

Obtaining an earlier diagnosis will benefit the servicemembers in several ways, Flynn said.

First, servicemembers who have a mild TBI will be identified on the spot.

"At the present time we have to rely on the soldier's history," said Flynn, who is also the chief of Neurobehavior and a staff neurologist at MAMC.  Second, servicemembers are being educated on what to look for before they deploy, so that if they suffer any of the symptoms they will know what to do.

Finally, the sooner a mild TBI is recognized, the better, Flynn said. An early diagnosis can cut down on the persistence of some of the symptoms, he said.

"What we are trying to do is educate the soldier about mild TBI before they walk out the door," Flynn said. "If they return and they are exhibiting any ongoing problems or deficits, we follow them in the clinic."

In order to ensure that all soldiers are checked out, a new protocol will be implemented in war zones that would "ensure that all troops who are near a roadside blast will be pulled out of combat for 24 hours and checked for a mild traumatic brain injury, even if they appear unhurt or say they are fine," according to a new treatment policy the Pentagon is planning to release.

"The new policy is a major expansion of battlefield medicine because it treats troops based on what happened to them, not just visible wounds," Air Force Col. Michael Jaffee, director of the Defense and Veterans Brain Injury Center, told the Army Times.