A changing landscape: traumatic brain injury in military combat and civilian athletics.

摘要

Diagnosing concussion has posed a special challenge in current military conflicts, as some symptoms and clinical findings are similar to acute stress reaction and other conditions. The Department of Defense (DoD) currently defines a traumatic brain injury (TBI) as: a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new onset or worsening of at least one of the following clinical signs, immediately following the event: 1) any period of loss of a decreased level of consciousness (LOC), 2) any loss of memory for events immediately before or after the injury, 3) any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc.), 4) neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc.) that may or may not be transient, or 5) the presence of an intracranial lesion (1).