Brain Trauma in Iraq

A few days into his tour of duty at the 86th Combat Support Hospital in Baghdad, Colonel Geoffrey Ling, a U.S. Army neurologist, noticed something unusual. Soldiers who had sustained severe head injuries in blasts from improvised explosive devices (IEDs) appeared to be in much worse shape than he would have expected given his experience with patients who had suffered seemingly similar injuries in car accidents and assaults. The brains of the injured soldiers were swollen and appeared “a very angry red,” he recalls. Some soldiers were conscious and could talk normally but were stumbling around the hospital, unable to keep their balance. “Their [brain] scans were stone-cold normal, and when you talked to them, they seemed fine,” says Ling, who is now a staff physician at Walter Reed Army Medical Center and a program manager in the Defense Sciences Office at the U.S. Defense Advanced Research Projects Agency (DARPA) in Arlington, VA. “But when I started testing them, like asking them to do addition, they were clearly not normal.”
By the time Ling arrived in Iraq, in 2005, thousands of U.S. soldiers had experienced IED attacks. While many of them had survived the concussive blasts, Ling and other physicians had begun to notice that a worrisome number were showing signs of brain damage. Ling, who is a neuroscientist as well as a neurologist, was puzzled. “Why does this injury look different?” he wondered. “What is it in the blast that’s causing it–the pressure, the noise, the cloud of fume?” After months of treating blast wounds in both American troops and Iraqi security forces, Ling had returned from his tour determined to wage war on brain injury. He knew that the answers to these questions could be crucial to protecting soldiers in the field and screening and treating them when they came home.

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