Management of Mild Traumatic Brain Injury
(mTBI) in the Military
February 13, 2020
On January 7, 2020, the Department of Defense (DOD) reported that the Islamic Republic of Iran
launched a number of ballistic missiles at certain Iraqi military bases hosting U.S. and coalition military
forces. These forces utilize Iraqi military bases to support counter-terrorism operations within the region,
including military actions against the Islamic State under Operation Inherent Resolve. DOD initially
reported no U.S. or coalition casualties, then later stated that 34 U.S. servicemembers assigned to these
locations were subsequently diagnosed with mild traumatic brain injury (mTBI) resulting from the
missile blasts. On February 10, 2020, numerous media sources reported that DOD revised its count to 109
servicemembers diagnosed, with 76 of those members already having returned to duty. These numbers
may increase in the future as servicemembers are further assessed.
This Insight provides a brief overview of DOD policies and programs to screen, assess, and manage
mTBI, which includes deployment-related concussions.
What is Traumatic Brain Injury?
DOD defines TBI as a “traumatically induced structural injury 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 after an event:
altered mental status;
memory loss (before or after the injury); or
decreased, or loss of, consciousness (self-reported or observed).
Examples of external forces include blunt trauma to the head, acceleration or deceleration movement to
the head, or exposure to blasts or explosions, including penetrating injuries. DOD organizes TBI
diagnoses into four levels of severity: mild, moderate, severe, and penetrating. An assessment conducted
at the time of the injury or event determines the level of severity. Individuals with TBI can experience a
wide variety of acute or chronic physical, cognitive, or emotional signs and symptoms.
