Sep 27 2007, 8:51 PM EST
News source: Business Wire
"For all of the right reasons, there has been an increase in awareness about traumatic brain injury in soldiers returning from Iraq and Afghanistan," says David Hovda. As professor and vice chief of research affairs for UCLA's Division of Neurosurgery and director of the UCLA Brain Injury Research Center, Hovda has several years experience in treating patients who have suffered traumatic brain injury (TBI) in sports injuries, car accidents and many other life-threatening situations. And Hovda and his neurosurgery team have made a number of breakthroughs in the field of brain injury.
Working in cooperation with Walter Reed Naval Medical Center over the last several years, Hovda says treating the soldiers who return from the Iraq war has yielded some interesting revelations. These have reframed TBI beyond sports medicine and tragic community folklore into a new way to treat head injuries from combat.
"Although severe TBI does occur in the Iraq and Afghanistan theaters, the most recent concern has been focused on the mild-to-moderate level of injury to the brain," he says. "Commonly referred to as concussions, these mild brain injuries often are due to individuals being in close proximity to blasts set off by improvised explosive devices. What is troubling is there is little being done to diagnose if an individual has sustained a mild or moderate TBI."
Often, Hovda says, when assessing a wounded soldier's injury, health care officials in the field rely on self-reports or subjective evaluations by medics and fellow soldiers. When those wounded soldiers return home, they frequently exhibit symptoms associated with "post-concussive symptoms." These symptoms include many psychological problems associated with learning, memory, emotions, coping and executive skills.
"The psychological impact of being exposed to combat alone is difficult enough to deal with," says Hovda.
"Veterans often succumb to chronic hopelessness and depression. However, we are just now starting to consider that these problems may be related to the mild to moderate head injuries they sustained in the war. We're finding these are not exclusively psychological repercussions."
The more he and his team study in this field, the more likely it is they can mitigate one of the most tragic consequences of combat.
"Here at UCLA Neurosurgery, we have been interested in the cells that have survived head injury," Hovda says. "We studied models of mild to moderate head injury and have been able to describe the neurobiological cascade of head injury - changes in neurochemistry, brain metabolism and receptor capabilities, all of which contribute to the brain being very vulnerable to a second concussion or other form of stress.
"More importantly," he adds, "it appears that parts of this cascade can produce long-term changes, such as the ability of the brain to learn, remember, or express appropriate emotion."
Such research into brain injuries, which affect over 17 million Americans, is slowly yielding insights into treatments. For example, UCLA neurosurgeons are now researching the use of lactate - long thought to be a "waste" chemical of the body - as a possible replacement "fuel" for the brain in the immediate hours after a traumatic brain injury. This lactate infusion replaces glucose, which is the current standard. If they are right, this could change how emergency room physicians and intensive care physicians treat patients with brain injuries in the first critical hours after injury.
Through Hovda's publications, his speaking engagements and the biennial UCLA Neurosurgery Visionary Ball fundraiser set for Oct. 4, Hovda and his team are using every tool they can to raise awareness and educate the public about their findings.
It is research like this, along with Hovda's and his team's discoveries linking TBI to what was previously considered wa
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