1. Mild Traumatic Brain Injury Information for Returning Service Members

2. What do They Have In Common? Ryan Church- New York Mets outfielder George Clooney - actor/director Ben Roethlisberger - Pittsburgh Steelers quarterback Mike Wallace - journalist

3. Answer: They have had one or more mild traumatic brain injuries (concussions) They received medical and rehabilitation help and support They returned to work

4. What is Traumatic Brain Injury? “…..is caused by a blow to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” a brief change in mental status or consciousness to “severe,” an extended period of unconsciousness or amnesia after injury” Centers for Disease Control & Prevention

5. Mild Brain Injury is the most common type of Brain Injury among civilians and service members About 80% of all civilian traumatic brain injuries are mild (CDC 2009) An estimated 11-20% of service members sustained a mild TBI/concussion while serving in OEF/OIF (US Army Surgeon General 2008, Hoge, et. al. 2008, Taneilian and Jaycox 2008)

6. Causes Civilians; Falls, Motor vehicle accidents, assaults, struck by/against events (CDC 2009) Service Members (injured in combat); Blast exposure, gunshot wounds, falls and motor vehicle accidents (Defense and Veterans Brain Injury Center 2009)

7. Question: Does a person always get “knocked out” or loose consciousness when they have a brain injury?

8. Answer: No!! They may however experience a period of feeling dazed, they may look fine, but their brains have been knocked “off line” and are unable to lay down new memories

9. For Example…..

10. “That first morning, wow, I didn’t want to move, I was thankful that nothing’s broken, but my brain was all scrambled” Ryan Church, New York Times 3/10/08 “All he remembers from the collision with Anderson is the aftermath, being helped off the field by two people, although he said he did not know who they were until he saw a photograph later” Ben Shpigel New York Times reporter

11. Signs of Mild Traumatic brain Injury Early Signs confusion blank staring decreased response time for directions and/or answering questions dizziness/sensitivity to light and/or sound vomiting headache nausea BIAA, Brain Injury Source Summer 2000, Vol.4, Issue 2, 30-37

12. For many, the symptoms go away within hours or days. If they do not and/or an individual gets another mild traumatic brain injury they may experience additional symptoms….

13. Signs of Mild Traumatic brain Injury Late Signs Persistent headache Poor attention Irritability/aggression Hearing problems Ringing in the ears Restlessness Depressed mood Decreased memory Sleep disturbances Fatigue and anxiety Blurry vision/visual problems Lightheadedness Difficulty making decisions BIAA, Brain Injury Source Summer 2000, Vol.4, Issue 2, 30-37

14. When to seek help... If things that have always come easily to you, are harder, take longer, especially if your ability to multi-task is not what it was prior to the incident and/or your family, friends, fellow soldiers or superiors comment negatively on performance of duties, your responsiveness to new situations and ability to communicate.

15. Per Army Behavioral Health, individuals concerned about lingering symptoms can... Speak to a chaplain Go to their installation Department of Behavioral Health or Community or Division Mental Health (www.behavioralhealth.army.mil) as well as... Thoroughly respond to the questions asked in the Post-Deployment Health Assessment (PDHA). Several items screen for possible traumatic brain injury

16. The Good News, with treatment and time the brain can heal!

17. Suggested services/strategies may include... Consultation with a neurologist and or a neuropsychologist Work with a speech, occupational, and or physical therapist as recommended by medical personnel Scheduling breaks/down time Minimize alcohol intake as it can depress brain cell growth/regeneration after injury Follow physician's recommendations for physical exercise-it supports brain health

18. Resources Defense and Veterans Brain Injury Center 1-800-870- 9244 www.dvbic.org. Check out video Survive, Thrive & Alive on brain injury and treatment and recovery of several injured service members. Brain Injury Association of America 703-236-6000, www.biausa.org Brain Injury Association of Maryland 410-448-2924, www.biamd.org Ohio Valley Center For Brain Injury Prevention and Rehabilitation, 614-293-3802, www.ohiovalley.org. www.headinjury.com. Good resource for memory aides and tips

19. A Product of the Maryland TBI Partnership Implementation Project, a collaborative effort between the Maryland Mental Hygiene Administration, the Mental Health Management Agency of Frederick County and the Howard County Mental Health Authority 2006-2009 Support is provided in part by project H21MC06759 from the Maternal and Child Health Bureau (title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Service This is in the public domain. Please duplicate and distribute widely

20. Anastasia Edmonston Project Director aedmonston@dhmh.state.md.us 410-402-8478