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11 CONCLUSIONS AND RECOMMENDATIONS
Pages 367-372

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From page 367...
... . The previous chapters detailed the numerous health effects that are associated with penetrating TBI and mild, moderate, and severe closed TBI.
From page 368...
... With regard to closed head injuries, the committee found sufficient evidence of an association between severe TBI and neurocognitive deficits, limited but suggestive evidence of an association between moderate TBI and neurocognitive deficits, and inadequate and insufficient evidence of an association between mild TBI and neurocognitive deficits. With regard to neurologic effects, the studies reviewed had numerous findings, including a strong association between TBI and unprovoked seizures.
From page 369...
... The committee concluded that there was sufficient evidence of an association between penetrating TBI and long-term unemployment and between moderate to severe TBI and long-term adverse social-function outcomes, particularly unemployment and diminished social relationships. However, the committee concluded that there was inadequate and insufficient evidence of an association between mild TBI and long-term adverse social functioning, including unemployment, diminished social relationships, and decrease in the ability to live independently.
From page 370...
... Nevertheless, use of additional TBI scoring systems is recommended, especially in the case of mild TBI or suspected concussion or when medical records provide less detailed information about the injury and its circumstances. In the military environment, use of the Brief Traumatic Brain Injury Screen and the Military Acute Concussion Evaluation is recommended for every soldier who has a history of blast exposure (even low-intensity blast exposure)
From page 371...
... The committee recommends that the Department of Veterans Affairs include, in the development of the Traumatic Brain Injury Veterans Health Registry (hereafter referred to as "the registry") , other service members who could provide a valid comparison for the analysis of outcomes.
From page 372...
... In an effort to understand the long-term outcomes of traumatic brain injury, including consequences that might be related to blast, the committee recommends that all deployed military personnel undergo predeployment neurocognitive testing. The committee also recommends postdeployment neurocognitive testing of representative samples of military personnel (including those with traumatic brain injury, those with other non-TBI injuries, and uninjured service members without blast exposure)


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