110 U.S. Service Members Diagnosed with Traumatic Brain Injuries from Iranian Missile Attack

110 U.S. service members have been diagnosed with mild traumatic brain injuries (TBI) from the Iranian missile attack on the Al-Asad Air Base in Iraq on Jan. 7, a Pentagon official said on Feb. 24.

Air Force Brig. Gen. (Dr.) Paul Friedrichs, the Joint Staff Surgeon at Pentagon’s Joint Chiefs of Staff (JCS), was speaking at a Pentagon news conference when he made the statement.

According to Brig. Gen. (Dr.) Friedrichs, most have returned to duty, while 25 returned to the United States for further treatment, and six more are still undergoing testing.

Following an attack, commanders assess injuries, Friedrichs said, and in this case, no one immediately appeared to have had acute injuries. “No one lost a leg, no one lost an eye, no one lost a limb — which was remarkable given the strength of these munitions,” the doctor said.

Therefore, he explained, reports went up the chain of command saying no one had an acute injury. But a TBI takes time to diagnose, and the process is involved. Protocols call for TBI testing of service members who were within 50 meters of an explosion, were exposed to a series of explosions, had a direct blow to the head, or who exhibit symptoms such as headache, dizziness, memory problems, balance problems, nausea, vomiting, difficulty concentrating, irritability and visual disturbance.

The tests take up to two days to complete. But service members may have TBI and feel they can power through and just go back to duty. They may have symptoms, but they don’t go away and may get worse, Friedrichs said.

While there are tests that can point to TBI, some cases also require an MRI. The closest MRI testing facility to Iraq is in Germany, adding to the delay in diagnosis.

Chairman of the Joint Chiefs of Staff Gen. Mark Milley indicated that the servicemembers in the Iranian attack will need to be monitored for the rest of their lives.

Reports surfaced on Jan. 13 that several troops were being assessed for possible concussions. Since then, the Department of Defense has officially revised the number of injured service members from the Iranian attack multiple times: 11 (January 17), 34 (January 24), 50 (January 28), and 64 (January 31). On February 10, reports surfaced that there are now over 100 TBI diagnosed service members.

Between 2000 and 2019, over 400,000 service members were diagnosed with traumatic brain injuries, including 15 percent of veterans returning from Iraq and Afghanistan. 43.9 percent of veterans with diagnosed TBI have co-occurring Post-traumatic stress disorder (PTSD).

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