Overview of Traumatic Brain Injury (TBI) in the Military

DESCRIPTION:

This training module defines and describes the different types of TBI.  It examines the rates of TBI in the military population with a focus on blast-related TBI.  Assessment and management of TBI will be covered. Finally, the training covers common comorbid conditions, treatment models, and resources for providers, families, and patients in the military with TBI.

LEARNING OBJECTIVES:

  1. Articulate the mechanisms of brain injury common in a military population.
  2. Evaluate methods of concussion assessment.
  3. Propose best intervention practices for providers working with traumatic brain injury.

OUTLINE:

  1. Definition of TBI
  2. Prevalence of TBI
    1. In the Military
    2. Severity data
  3. Mechanisms of TBI
    1. Closed/blunt

      1. Coup & Contra Coup
      2. Diffuse axonal injury
    2. Blast waves and blast-related injuries
      1. Primary injuries
      2. Secondary, tertiary, and quarternary injuries
  4. Case Study: SFC Bradley Lee
  5. Neurocognitive Disorder
    1. DSM-5 criteria
    2. Distinguishing between Mild and Major NCD
    3. Predisposing NCD risk factors
  6. TBI screening and assessment
    1. Assessment domains
    2. Assessment tools
    3. Screening errors and preventing misdiagnoses/missed diagnoses
  7. Changes after a TBI
    1. Cognitive
    2. Emotional, Behavioral, and Social
    3. Long-term challenges and controversies
  8. Comorbidities and other factors
    1. Post-deployment disorders
    2. Concussion and PTSD
    3. Concussion and depression
    4. Concussion and AUD
    5. Concussion and sleep
    6. Concussion and suicide risk
  9. Interventions following Concussion
    1. Best practices for providers
    2. Case study: SFC Bradley Lee
    3. Clinical course
    4. Complications with clinical course
    5. Psychoeducation
    6. Specific interventions
      1. Compensatory Cognitive Training
      2. Veterans’ In-Home Program
    7. Treating comorbidities
    8. Take Home Points
  10. TBI Resources
    1. Concussion Coach
    2. A Head for the Future
    3. Other DVBIC tools
    4. VA/DoD Clinical Practice Guidelines
    5. Websites
    6. Consultation tools
    7. TBI caregivers guide