![]() Therefore, for a patient with a TBI and ASD, it is difficult to determine whether the dissociative symptoms are related to the injury or are in response to extreme psychological trauma. 14 The dissociative symptoms associated with ASD are similar to symptoms of TBI, including feeling dazed or confused, loss of memory of the event, and disorientation. In addition, three or more of the following dissociative symptoms must be present: numbing or detachment from emotions, reduction in awareness of surroundings, derealization, depersonalization, and dissociative amnesia. For instance, acute stress disorder (ASD) requires at least one symptom from each of the following domains: re-experiencing (e.g., recollections, images, nightmares), avoidance of reminders of the traumatic event, and hyperarousal. Other psychological symptoms may complicate a clear diagnosis of TBI. Persistent symptoms that continue to be present 6 mo after the initial mTBI are referred to as post-concussion syndrome (PCS). 11 In most cases, symptoms related to an mTBI abate within 2 wk after the head injury. ![]() 9, 10 The symptoms of mTBI include exposure to a blast or other head injury event resulting in (1) a loss of consciousness less than 30 min, (2) incomplete or partial memory of the event that caused the injury, and/or (3) feeling disoriented, dazed, or confused. ![]() More than 80% of all deployment-related TBIs are categorized as mild TBIs (mTBI) and are commonly referred to as concussions. TBIs are categorized as mild, moderate, or severe. Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) have been referred to as “signature injuries” of OEF/OIF and are common sequelae of blast exposures. 2– 6 Blast exposure can result in a spectrum of physical and neurocognitive injuries related to primary (pressure of the blast), secondary (projectile objects), tertiary (being thrown into other objects), and quaternary (electromagnetic radiation, poisonous gas from exposure, etc.) events. 1 Blast-related injuries accounted for about 80% of all injuries during OEF/OIF deployments. The prevalence of blast-related injuries has been estimated to be about 15% in military personnel deployed in support of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Deployed military service members are at increased risk of sustaining a deployment-related head injury from exposure to an explosive blast or other events.
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