After the 24-hour span of time, the soldier or Marine is again assessed
in terms of their symptoms and the
cognitive testing and a brief neurological score
that will be a part of this to see, "Are they okay?"
as best we can tell in that screening assessment.
And then determined, if they are symptom-free and they have nothing wrong
that anybody can detect on examination--
those individuals then will be released to return.
Otherwise, they stay back.
And there's even a different part of it now.
The new protocol will require individuals who have had three concussions
over a 12-month span, now that we're able to track it in this new system--
if we can say, "This is your third. You now undergo a more detailed
evaluation before we clear you to go back."
Even if they think they're fine after the third, and they pass the screening exam,
if they've had three, they go to a different level of neurological evaluation.
It's actually fairly common for individuals to have symptoms show up
days, weeks, even months later.
And what we advocate is watching, monitoring
for those symptoms real-time, day to day,
week to week, and so forth with a variety of things done to see,
"Are you really who you were before the injury?" as best we're able to do that.
Some of that has to do with, in the sports setting, having an opportunity to
examine the athlete beforehand and then do comparisons to those
earlier, pre-injury, assessments.
That opportunity may also be available in the military before too long,
and parts of it are being done now.
But on a system-wide basis with thousands and thousands of people that are
engaged in that kind of pre-deployment testing, we don't really have it all ironed out
as to how to do that right and what measures are best and what way we can
tell who that individual is at a given time in order to compare against all
of what happens to them in the meantime,
much of which is not concussive, and all of the other things that change a person
because of a war experience. And we don't really pretend to understand
all of those factors right now.
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Soldiers who have sustained three concussions will receive a more detailed, mandatory evaluation before returning to combat.
Produced by Noel Gunther and Brian King, BrainLine.
James Kelly, MD is the director of the National Intrepid Center of Excellence. As a neurologist, he is one of America’s top experts on treating concussions.
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