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HOW DOES BLAST EXPOSURE CAUSE A CONCUSSION OR A TRAUMATIC BRAIN INJURY?
A TBI is caused by a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Exposure to blast events can affect the body in a number of ways; in addition, these different injuries mechanisms can interact and result in more impairments or prolonged periods of recovery.
Primary blast injury is the result of exposure to the over pressurization wave or the complex pressure wave that is generated by the blast itself. This blast over-pressurization wave travels at a high velocity and is affected by the surrounding environment; for example, the effects of the blast wave may be increased in a closed environment such as a vehicle. Air-filled organs such as the ear, lung, and gastrointestinal tract and organs surrounded by fluid-filled cavities such as the brain and spinal cord are especially susceptible to primary blast injury (Elsayed, 1997; Mayorga, 1997). The over pressurization wave dissipates quickly, causing the greatest risk of injury to those closest to the explosion.
Secondary blast injury is the result of energized fragments flying through the air; these fragments may cause penetrating brain injury.
Tertiary blast injury may occur when the individual is thrown from the blast into a solid object such as a adjacent wall or even a steering wheel. These types of injuries are associated with acceleration/ deceleration forces and blunt force trauma to the brain similar to that observed following high speed motor vehicle accidents.
Finally,
quaternary blast injury can occur in the presence of severe blast related trauma resulting from significant blood loss associated with traumatic amputations or even from inhalation of toxic gases resulting from the explosion.
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