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Neurosurgeon Links Returning Veterans with Brain Injury

Pew research led by Julian Bailes, MD, Chairman of the Department of Neurosurgery and Co- Director of the NorthShore University HealthSystem (NorthShore) Neurological Institute (NNI), shows that the long-term effects of head injuries suffered by military personnel in combat resemble trauma observed in professional athletes who experienced repetitive concussions and other types of brain injuries.

“This is our second report of brain damage seen at autopsy in military veterans who had multiple traumatic head injuries from improvised explosive devices, or IEDs, and exhibited signs of chronic traumatic encephalopathy, or CTE,” said Dr. Bailes. Dr. Bailes is a national leader in the field of neurosurgery and among the first researchers to establish a link between returning veterans and CTE.

CTE is a progressive, degenerative disease caused by repeated concussions and other traumatic head injuries. Symptoms include cognitive impairment, memory loss, behavioral problems, depression and other mood disorders, and substance abuse.

“The real importance of this finding is that it demonstrates a portion of service members diagnosed with post-traumatic stress disorder, or PTSD, possibly could be suffering from the long-term effects of concussions,” said Dr. Bailes.

In the study, recently published in the Journal of Neurosurgery, researchers identified the hallmark changes of CTE in the brain of a 27-year-old Iraqi war veteran who had been exposed to multiple mortar blasts and IEDs. The serviceman was diagnosed with PTSD and committed suicide eight months after discharge. An autopsy revealed findings, such as a unique pattern of neurofibrillary tangles—or protein deposits—that were similar to CTE changes in athletes.

According to Dr. Bailes, concussions as a result of explosive devices are the number-one brain injury seen in returning veterans. Between 18 and 30 percent of these troops develop neuropsychiatric impairments that are diagnosed as PTSD.

Dr. Bailes—the Arlene and Marshall Bennett and Joseph A. Tarkington, MD, Chair of Neurosurgery—is leading the way to help medical science better understand the lingering effects of these types of brain injuries.

He is already a renowned expert for his work on concussions in sports and their long-term consequences. He deals with sports-related concussions firsthand by serving as Medical Director of Pop Warner Football, the largest youth football league in the U.S., and also has served as neurological consultant to the National Football League (NFL) Players’ Association.

Dr. Bailes’ research is running in tandem with the work of Felise Zollman, MD, the new Director of the NorthShore Memory Disorders Program and a leader, along with Dr. Bailes, in NNI’s Sports Concussion Program.

“Athletes, veterans and other at-risk groups need to be aware of the still-emerging understanding of the potential for long-term adverse effects from blows to the head,” said Dr. Zollman. “As we continue to do research, our hope is to determine who is at highest risk of developing problems, such as CTE, from repeated concussions and how to prevent these later complications.”

Dr. Bailes explained that in the past decade researchers have learned more about concussions and other head injuries than ever before, particularly among athletes. “We are just now beginning to better understand the high incidence of concussion also among the military,” he said.