Article

Blasts are responsible for about two-thirds of the combat injuries in Operation
Iraqi Freedom and Operation Enduring Freedom, which include at least 1,200
traumatic brain injuries. Blasts inflict damage to the brain directly and by
causing injuries to other organs, resulting in air emboli, hypoxia, and shock.
Direct injuries to the brain result from rapid shifts in air pressure (primary
blast injury), from impacts with munitions fragments and other objects propelled
by the explosion (secondary blast injury), and from collisions with objects and
rapid acceleration of individuals propelled by the explosion (tertiary blast
injury). Tertiary injury can occur from a building or other structure collapsing
and from an individual being thrown by the blast wind. The pathological
consequences of secondary and tertiary blast injuries are very likely to be
similar to those of other types of mechanical trauma seen in civilian life. The
damage attributable to the specific effects of a blast, however, has received
little study, although it has been assumed to include the focal and diffuse
lesions characteristic of closed head injuries. Available clinical studies of
blast injuries show focal damage similar to that found in other types of closed
head injuries but have not determined whether diffuse axonal injury also occurs.
In this article, we will try to reach a better understanding of the specific
pathology of blast-related brain injury by reviewing the available experimental
studies and the autopsy reports of victims of terrorist attacks and military
casualties dating back to World War I.

Langue : ANGLAIS