Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Omalu, B; Hammers, J L; Bailes, J; Hamilton, R L; Kamboh, M I; Webster, G; Fitzsimmons, R P
Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide Journal Article
In: Neurosurgical Focus, vol. 31, no. 5, pp. E3, 2011.
Abstract | BibTeX | Tags: *Blast Injuries/pa [Pathology], *Blast Injuries/pp [Physiopathology], *Brain Injury, *Combat Disorders/pp [Physiopathology], *Suicide/px [Psychology], 2003-2011, adult, Blast Injuries/co [Complications], Brain Injury, Chronic/co [Complications], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Combat Disorders/px [Psychology], Humans, Iraq War, Male, Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Stress Disorders, Suicide/pc [Prevention & Control]
@article{Omalu2011,
title = {Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide},
author = {Omalu, B and Hammers, J L and Bailes, J and Hamilton, R L and Kamboh, M I and Webster, G and Fitzsimmons, R P},
year = {2011},
date = {2011-01-01},
journal = {Neurosurgical Focus},
volume = {31},
number = {5},
pages = {E3},
abstract = {Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than 50 m away. Following his second deployment he developed a progressive history of cognitive impairment, impaired memory, behavioral and mood disorders, and alcohol abuse. Neuropsychiatric assessment revealed a diagnosis of PTSD with hyperarousal (irritability and insomnia) and numbing. He committed suicide approximately 8 months after his honorable discharge from the USMC. His brain at autopsy appeared grossly unremarkable except for congestive brain swelling. There was no atrophy or remote focal traumatic brain injury such as contusional necrosis or hemorrhage. Histochemical and immunohistochemical brain tissue analysis revealed CTE changes comprising multifocal, neocortical, and subcortical neurofibrillary tangles and neuritic threads (ranging from none, to sparse, to frequent) with the skip phenomenon, accentuated in the depths of sulci and in the frontal cortex. The subcortical white matter showed mild rarefaction, sparse perivascular and neuropil infiltration by histiocytes, and mild fibrillary astrogliosis. Apolipoprotein E genotype was 3/4. The authors report this case as a sentinel case of CTE in an Iraqi war veteran diagnosed with PTSD to possibly stimulate new lines of thought and research in the possible pathoetiology and pathogenesis of PTSD in military veterans as part of the CTE spectrum of diseases, and as chronic sequelae and outcomes of repetitive traumatic brain injuries.},
keywords = {*Blast Injuries/pa [Pathology], *Blast Injuries/pp [Physiopathology], *Brain Injury, *Combat Disorders/pp [Physiopathology], *Suicide/px [Psychology], 2003-2011, adult, Blast Injuries/co [Complications], Brain Injury, Chronic/co [Complications], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Combat Disorders/px [Psychology], Humans, Iraq War, Male, Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Stress Disorders, Suicide/pc [Prevention \& Control]},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Omalu, B; Hammers, J L; Bailes, J; Hamilton, R L; Kamboh, M I; Webster, G; Fitzsimmons, R P
Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide Journal Article
In: Neurosurgical Focus, vol. 31, no. 5, pp. E3, 2011.
@article{Omalu2011,
title = {Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide},
author = {Omalu, B and Hammers, J L and Bailes, J and Hamilton, R L and Kamboh, M I and Webster, G and Fitzsimmons, R P},
year = {2011},
date = {2011-01-01},
journal = {Neurosurgical Focus},
volume = {31},
number = {5},
pages = {E3},
abstract = {Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than 50 m away. Following his second deployment he developed a progressive history of cognitive impairment, impaired memory, behavioral and mood disorders, and alcohol abuse. Neuropsychiatric assessment revealed a diagnosis of PTSD with hyperarousal (irritability and insomnia) and numbing. He committed suicide approximately 8 months after his honorable discharge from the USMC. His brain at autopsy appeared grossly unremarkable except for congestive brain swelling. There was no atrophy or remote focal traumatic brain injury such as contusional necrosis or hemorrhage. Histochemical and immunohistochemical brain tissue analysis revealed CTE changes comprising multifocal, neocortical, and subcortical neurofibrillary tangles and neuritic threads (ranging from none, to sparse, to frequent) with the skip phenomenon, accentuated in the depths of sulci and in the frontal cortex. The subcortical white matter showed mild rarefaction, sparse perivascular and neuropil infiltration by histiocytes, and mild fibrillary astrogliosis. Apolipoprotein E genotype was 3/4. The authors report this case as a sentinel case of CTE in an Iraqi war veteran diagnosed with PTSD to possibly stimulate new lines of thought and research in the possible pathoetiology and pathogenesis of PTSD in military veterans as part of the CTE spectrum of diseases, and as chronic sequelae and outcomes of repetitive traumatic brain injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bailie, J M; Kennedy, J E; French, L M; Marshall, K; Prokhorenko, O; Asmussen, S; Reid, M W; Qashu, F; Brickell, T A; Lange, R T
Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes Journal Article
In: Journal of Head Trauma Rehabilitation, vol. 31, no. 1, pp. 2–12, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult
@article{Bailie2016,
title = {Profile Analysis of the Neurobehavioral and Psychiatric Symptoms Following Combat-Related Mild Traumatic Brain Injury: Identification of Subtypes},
author = {Bailie, J M and Kennedy, J E and French, L M and Marshall, K and Prokhorenko, O and Asmussen, S and Reid, M W and Qashu, F and Brickell, T A and Lange, R T},
year = {2016},
date = {2016-01-01},
journal = {Journal of Head Trauma Rehabilitation},
volume = {31},
number = {1},
pages = {2--12},
abstract = {OBJECTIVE: To explore the taxonomy of combat-related mild traumatic brain injury (mTBI) based on symptom patterns. PARTICIPANTS: Up to 1341 military personnel who experienced a combat-related mTBI within 2 years of evaluation. MEASURES: Neurobehavioral Symptom Inventory and PTSD Checklist-Civilian Version (PCL-C). RESULTS: Cluster analysis revealed the following 4 subtypes: primarily psychiatric (posttraumatic stress disorder) group, a cognitive group, a mixed symptom group, and a good recovery group. The posttraumatic stress disorder cluster (21.9% of the sample) reported symptoms related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The cognitive group (21.5% of the sample) had primarily cognitive and headache complaints with few mood symptoms. The mixed profile cluster included 18.6% of the sample and was characterized by a combination of mood complaints (hyperarousal and dissociation/depression), cognitive complaints, and headaches. The largest cluster (37.8% of the sample) had an overall low symptom profile and was labeled the "good recovery" group. CONCLUSIONS: The results support a unique taxonomy for combat-related mTBI. The clinical differences among these subtypes indicate a need for unique treatment resources and programs.},
keywords = {*Brain Injuries/co [Complications], *Military Personnel, Abbreviated Injury Scale, Adolescent, adult, Brain Injuries/px [Psychology], Cluster Analysis, Cognition Disorders/et [Etiology], Cognition Disorders/px [Psychology], FACTOR analysis, Headache/et [Etiology], Headache/px [Psychology], Humans, Male, middle aged, Mood Disorders/et [Etiology], Mood Disorders/px [Psychology], Neuropsychological Tests, Post-Traumatic/et [Etiology], Post-Traumatic/px [Psychology], Statistical, Stress Disorders, UNITED States, Warfare, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Lau, K M; Madden, E; Neylan, T C; Seal, K H; Maguen, S
Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors Journal Article
In: Brain Injury, vol. 30, no. 3, pp. 287–294, 2016.
Abstract | BibTeX | Tags: *Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics & Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs
@article{Lau2016a,
title = {Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors},
author = {Lau, K M and Madden, E and Neylan, T C and Seal, K H and Maguen, S},
year = {2016},
date = {2016-01-01},
journal = {Brain Injury},
volume = {30},
number = {3},
pages = {287--294},
abstract = {OBJECTIVE: To investigate injury severity markers and neurological symptoms associated with clinician-confirmed mild traumatic brain injury (TBI) among Iraq and Afghanistan veterans. SETTING: Department of Veterans Affairs (VA) medical centre and five affiliated community-based outpatient clinics. PARTICIPANTS: Three hundred and fifty Iraq and Afghanistan veterans with positive initial VA TBI screens between 1 April 2007 and 1 June 2010 and clinician-confirmed TBI status by 1 December 2010. METHODS: Retrospective-cohort study of medical record data. Main measures included clinician-confirmed TBI status, injury severity markers (e.g. loss of consciousness (LOC), post-traumatic amnesia (PTA) or confusion/disorientation) and neurological symptoms. RESULTS: Among veterans who screened positive on the initial VA TBI and then received a clinician evaluation, 60% were confirmed to have a TBI diagnosis. Veterans reporting at least one LOC, confusion or PTA were almost 18-times more likely to receive a confirmed TBI diagnosis. Odds of clinician-confirmed TBI were 2.5-3-times greater among those who endorsed dizziness, poor coordination, headaches, nausea, vision problems and/or irritability, compared to those not endorsing these symptoms. Nausea had greatest utility for confirming a TBI. CONCLUSIONS: Identification of neurologic symptoms that most contribute to a clinician-confirmed diagnosis of TBI has potential for streamlining detection of TBI and symptoms needed for treatment.},
keywords = {*Afghan Campaign 2001-, *Brain Concussion/di [Diagnosis], *Iraq War, *Veterans/sn [Statistics \& Numerical Data], 2003-2011, adult, Brain Concussion/pp [Physiopathology], Brain Concussion/px [Psychology], Cohort Studies, Female, Humans, Injury Severity Score, Male, middle aged, Military personnel, Post-Traumatic/di [Diagnosis], Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Retrospective Studies, self report, Stress Disorders, UNITED States, United States Department of Veterans Affairs},
pubstate = {published},
tppubtype = {article}
}
Omalu, B; Hammers, J L; Bailes, J; Hamilton, R L; Kamboh, M I; Webster, G; Fitzsimmons, R P
Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide Journal Article
In: Neurosurgical Focus, vol. 31, no. 5, pp. E3, 2011.
Abstract | BibTeX | Tags: *Blast Injuries/pa [Pathology], *Blast Injuries/pp [Physiopathology], *Brain Injury, *Combat Disorders/pp [Physiopathology], *Suicide/px [Psychology], 2003-2011, adult, Blast Injuries/co [Complications], Brain Injury, Chronic/co [Complications], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Combat Disorders/px [Psychology], Humans, Iraq War, Male, Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Stress Disorders, Suicide/pc [Prevention & Control]
@article{Omalu2011,
title = {Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide},
author = {Omalu, B and Hammers, J L and Bailes, J and Hamilton, R L and Kamboh, M I and Webster, G and Fitzsimmons, R P},
year = {2011},
date = {2011-01-01},
journal = {Neurosurgical Focus},
volume = {31},
number = {5},
pages = {E3},
abstract = {Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than 50 m away. Following his second deployment he developed a progressive history of cognitive impairment, impaired memory, behavioral and mood disorders, and alcohol abuse. Neuropsychiatric assessment revealed a diagnosis of PTSD with hyperarousal (irritability and insomnia) and numbing. He committed suicide approximately 8 months after his honorable discharge from the USMC. His brain at autopsy appeared grossly unremarkable except for congestive brain swelling. There was no atrophy or remote focal traumatic brain injury such as contusional necrosis or hemorrhage. Histochemical and immunohistochemical brain tissue analysis revealed CTE changes comprising multifocal, neocortical, and subcortical neurofibrillary tangles and neuritic threads (ranging from none, to sparse, to frequent) with the skip phenomenon, accentuated in the depths of sulci and in the frontal cortex. The subcortical white matter showed mild rarefaction, sparse perivascular and neuropil infiltration by histiocytes, and mild fibrillary astrogliosis. Apolipoprotein E genotype was 3/4. The authors report this case as a sentinel case of CTE in an Iraqi war veteran diagnosed with PTSD to possibly stimulate new lines of thought and research in the possible pathoetiology and pathogenesis of PTSD in military veterans as part of the CTE spectrum of diseases, and as chronic sequelae and outcomes of repetitive traumatic brain injuries.},
keywords = {*Blast Injuries/pa [Pathology], *Blast Injuries/pp [Physiopathology], *Brain Injury, *Combat Disorders/pp [Physiopathology], *Suicide/px [Psychology], 2003-2011, adult, Blast Injuries/co [Complications], Brain Injury, Chronic/co [Complications], Chronic/pa [Pathology], Chronic/pp [Physiopathology], Combat Disorders/px [Psychology], Humans, Iraq War, Male, Post-Traumatic/pp [Physiopatholo, Post-Traumatic/px [Psychology], Stress Disorders, Suicide/pc [Prevention \& Control]},
pubstate = {published},
tppubtype = {article}
}