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About the Authors:
Peethambaran Arun
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Samuel Oguntayo
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Yonas Alamneh
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Cary Honnold
Affiliation: Veterinary Services Program, Division of Pathology, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Ying Wang
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Manojkumar Valiyaveettil
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Joseph B. Long
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Madhusoodana P. Nambiar
* E-mail: [email protected]
Affiliation: Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
Introduction
The frequency of blast-induced traumatic brain injury (blast TBI) has been increased tremendously in the recent conflicts due to the high use of improvised explosive devises [1], [2]. Although the precise cause and mechanisms of blast TBI remains unclear, blast TBI shares clinical features of both penetrating TBI and closed-head TBI [3]. The uniqueness of blast TBI compared to other types of TBI is concurrent organ injury and polytrauma due to the whole body exposure to blast. Hemorrhage, inflammation and oxidative stress after blast exposure are not only confined to brain but also occur in other gas filled body organs such as lungs, gastrointestinal tracts and auditory systems [4]–[8].
The neuropathology and subsequent cognitive deficits after blast exposure are proposed to be a cumulative effect of direct blast overpressure effect on the brain along with damage to other body organs [9]–[11]. Protective Kevlar body vests decreased the mortality, neuropathology and behavioral deficits in rats exposed to blast overpressure supporting the notion that polytrauma and systemic effects significantly contribute to...