Want to minimize a serious war injury? Call it “minor” Traumatic Brain Injury (TBI), and then fail to report it to the public?

“Mild” TBI in wartime is often caused by being near an explosion, but not close enough to get broken bones or skin, flesh, or burn injuries.

TBI is sneaky. It attacks a special weakness in the brain. When a sufficiently loud explosion is heard — even from something as simple as a sonic boom from a low-flying aircraft, let alone from a missile attack — the brain physically receives the blast wave and jiggles and vibrates like a bowl full of jelly.

Those vibrations do the damage. They create microscopic cracks in the brain that break the ganglion synapses that unify thought — the connections from one brain cell to another that make you a reasoning person.

That is why people living with TBI often have blank spots in their memories. The memory may still be there, but it is not connected to anything, and sadly it may never be.

Why is there often no recovery from the first injury? Because it usually gets worse. The broken synapses start growing rapidly, searching for a match. They grow in random directions, hook up to the wrong cells, and those new connections almost never help.

Now picture millions of brain cells doing the same thing. The random growth becomes a snarl, like snarled yarn. That often leads to early-onset dementia.

The harm is made worse when the injury is hidden or played down. That denigrates the service of soldiers, sailors, Marines, and airmen. Family and friends are less likely to notice what comes later. The veteran is less likely to seek care — the “shake it off” effect.

In fact, “mild TBI” may be the Agent Orange of this generation of veterans: quiet, easy to forget, and then a cause of early death from dementia for someone who may never have received a Purple Heart.

Veterans and families who suspect blast exposure should not wait for someone else to take it seriously. Get evaluated. Keep records. Ask for follow-on care.

Learn more about VNRC’s veteran support at [vnrc.us](https://vnrc.us).