b'All is Not Well When Concussion is Partof the EquationWhenPresident Donald Trump tweeted All isinjuries. This means they require a different type and level well! after an Iranian missile attack on twoof treatment. In recognition of this, the military has even American military bases in Iraq on January 8th, 2020, hedeveloped and refined one of the most sophisticated brain illustrated one of the most insidious issues the brain injuryinjury assessments to date, the Military Acute Concussion community faces: the chronic underestimation of the seri- Evaluation, or MACE II. Dr. Clint Pearman, who assisted in ousness of concussion. the development, was even part of the BIAAZs Brain Injury Concussions are particularly dangerous for service mem- Alliance Concussion Day community training in 2019.bers, as they may have an increased risk of second-impactAdditionally, although symptoms of mild concussions syndrome (SIS)catastrophic brain swelling can occurwere previously thought to clear up on their own after some when the brain is still manifesting symptoms from a first,time, new research suggests concussions could potentially initial concussion. impact a persons health years later. The impacts are exac-In the aftermath of the attacks, U.S. Central Commanderbated the more concussions a person sustains. When you issued a statement that said several soldiers were treatedfactor in blast injuries with the routine, bumps, blows, and for concussion symptoms from the blast, and that perjolts to the head that any one of us is at risk for from slips, standard procedure, all personnel in the vicinity of a blastfalls, car accidents, and more you can see the unique are screened for traumatic brain injury, and if deemed ap- situation our military members are in, which requires a propriate, are transported to a higher level of care. To date,coordinated response and sophisticated level of awareness.109 soldiers were treated for brain injury. What all this means is there is no such thing as all being The immediate assessment and treatment of troops afterwell when soldiers are near ballistic strikes. At the very the missile attacks illustrates how far the U.S. military hasleast, the risk of concussion is present, if not second-impact come in terms of the most common injury service memberssyndrome. To act as though this isnt the case is at best dan-sustain. Ten years ago, concussions were under-diagnosed,gerous ignorance, and at worst, publishing false information leading many service members to grapple with the long- to a mass audience.terms effects of their traumatic brain injury on their ownKudos to the military for the immediate understanding with often disastrous consequences for the soldier and theirof how serious a threat two hours of ballistic missile strikes loved ones. were for our service men and women and acting accordingly. Today, concussion assessment and treatment is standard.It is a perfect illustration that whether from a fall on the The government has created the Defense and Veteransplayground, a car accident, or a ballistic missile attack, con-Brain Injury Center (DVBIC), now an integrated part of thecussions are serious and should be treated as such. Also, the military health care system. This is particularly importantfull impact of a brain injury often emerges over days or even because the conditions under which troops most often sus- weeks after the event.We must be careful not to declare tain a brain injury are vastly different than a professionalan immediate all is well, but rather give each athlete, another population plagued by repeated headindividual the time they need to assess and heal.22 The Noggin | 2020vol 5issue 1'