![]() The obvious concern is when, not if, the practice will spread to the United States. ![]() 2 Unfortunately, the threat of suicide bombing seems to have spread from the Near East to the Far East and back to Europe, as evidenced by both the Madrid and London attacks. But it is only since the advent of terrorist suicide bombings that civilian physicians have become significantly concerned about the cause and treatment of blast injuries. 3 Following WWII, blast injury was intensively investigated in the United States, due to the perceived threat of nuclear warfare. "Blast lung" was the term coined for massive pulmonary hemorrhage from disruption of the alveolar architecture and formation of alveolar-venous fistulas resulting in air embolism. In WWII, a noteworthy number of casualties were found among civilians in both German and British cities after bombing raids. During WWI, blast injury was thought to be a nervous system disorder and labeled "shell shock." (At that time, sychological casualties were lumped together with those who had no visible injuries.) 2 1 Rusca went on to use rabbits as an animal model and demonstrated that the cause of death was pulmonary embolism. ![]() We accomplished this goal by conducting advanced neuroimaging task-activated fMRI and DTI fiber tracking and neurobehavioral testing computerized assessment and standard neuropsychological testing on 60 chronic trauma patients 15 military MTBI patients with blast injuries, 15 civilian MTBI patients with mechanical closed head injuries,15 military and 15 civilian patients with orthopedic injuries.Our knowledge of the effects of blast injury dates from the Balkan wars in 1914, when Franchino Rusca, a Swiss researcher, observed 3 soldiers who had been killed by an explosion without evidence of any external in-juries. This was accomplished by comparing neurobehavioral and neuroimaging findings obtained from military personnel who had a blast injury with those obtained from civilians who sustained TBI from motor vehicle accidents and from military and civilian control participants with orthopedic injuries. In this cross-sectional study, we applied neurobehavioral testing and advanced MRI techniques task-activated functional MRI fMRI and diffusion tensor imaging DTI to gain a comprehensive understanding of the neural changes underlying blast-related MTBI. Understanding the potentially unique sequelae of blast-related TBI is critical for accurate diagnosis and designing effective pharmacological and neurorehabilitation interventions. It is unknown whether the neural and cognitive sequelae of blast-related TBI differ from those resulting from mechanically-induced TBI commonly observed in civilian accidents. Blasts produce wave-induced changes in atmospheric pressure, which in turn produce characteristic injuries to vulnerable bodily regions at air-fluid interfaces, such as the middle ear. TBI from exposure to an explosive blast may also result from a third cause barotrauma. Like civilian TBI, blast-related TBI can result from mechanical forces in which objects in motion strike the head or the head is forcefully put into motion and strikes an object. Abstract: Traumatic brain injury TBI is a common occurrence from roadside blasts of improvised explosive devices IEDs.
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