It should not be surprising that there are lingering effects from a battle concussion, what may be surprising is the sheer amount of service men and women that may be affected daily by just headaches. Recent data published in Headache by Army researchers shows that nearly 20% of soldiers that sustained a concussive episode had been diagnosed with “chronic daily headache”;
Of those, a quarter had the headaches every day. More soldiers with chronic headaches had symptoms of post traumatic stress disorder (PTSD) than those who did not suffer frequent headaches. […]
The chronic headache group was also more likely to score higher on a test for signs of PTSD. Nearly twice as many with chronic headache – 41 percent – screened positive for PTSD, compared with 18 percent who didn’t have headaches as often.
The finding that more soldiers with chronic daily headache also had PTSD symptoms supports the idea that the headaches could be related to the actual physical brain injury or to the psychological trauma of the event that caused the concussion.
It is unknown how these data match up with the general population or the population of sports concussions, regardless this can be a very interesting finding. Some questions come to mind:
- Does the HA affect performance in theater?
- Does the HA impact the surrounding unit?
- Will intervention of the HA cause an issue with deployment and responsibilities?
Again the military is using the resources at its disposal to stay in front of the developing issues.
The Concussion Blog 
Shell shocked,
Battle fatigue,
mTBI/concussion and PTSD
All 3 terms represent present day conceptions of the significant and adverse fallout from soldiers encountering the war zone.
As knowledge has emerged re the adverse effects of exposure to blasts …the earlier term of “shell shocked” now appears to be prophetic and precise.
What needs to be further addressed for our current soldiers is the adverse psychological impact of having to weather MULTIPLE TOURS of duty within a war zone. Arguably, multiple tours alone can create much more psychological stress for the armed service personnel.
Furthermore, the soldier’s PTSD may not necessarily be “psychological” but organically/physiologically based due the blast induced and/or falls/whiplash effect (i.e., blast under vehicle flips vehicle and passengers) that cause brain injury within areas of the brain that impact a solder’s emotions (Descartes’ Error applies).
Finally, circa this past year it was reported in my local newspaper that an area soldier died from enemy fire ONLY several days after he reportedly suffered a concussion during battle…
Seems, based on the newspaper report…there was no existing return to battle (RTB)
protocol…after sustaining a concussion.
What also needs to be mentioned that has been reported in the literature is otolithic dysfunction of the vestibular is extremely common with these blast injuries causing gaze instabilities and headaches. Dynamic Visual Acuity (DVA) Testing and Gaze Stabilization Test (GST) can often reveal this hypofunction of gaze and vestibular rehabilitation can ameliorate these symptoms if identified. We rarely hear of this testing in the literature of the athlete let alone the labyrinthine concussed soldier. NATUS International (formerly NeuroCOM) has the InVision system that can measure these gaze instabilities objectively and is a standard assesment tool used in our faciities to assess dizziness symptoms (headache being one) yet is rarely in never mentioned in the discussions on concussion management.