More and more US troops battered in Iran's missile attack have traumatic brain injuries, and it could be a problem for the rest of their lives

AP Photo/Ali Abdul HassanA U.S. soldier stands while bulldozers clear rubble and debris at Ain al-Asad air base in Anbar, Iraq, Monday, Jan. 13, 2020.
  • The number of US service members diagnosed with mild traumatic brain injuries following the Jan. 8 Iranian missile attack has jumped from 11 – a figure reported one week after the president said “no Americans were harmed” – to 64.
  • “There’s nothing mild about a brain injury,” Michael Kaplen, a brain injury expert, told Insider, adding that these types of injuries can easily become chronic conditions that require long-term support.
  • While President Donald Trump characterised the injuries as “not very serious,” the Pentagon said Thursday it is taking them seriously.
  • “We’ll continue to monitor them the rest of their lives and continue to provide whatever treatment is necessary,” Chairman of the Joint Chiefs of Staff Gen. Mark Milley explained.
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Dozens of US service members suffered traumatic brain injuries in an Iranian missile attack in Iraq, and it’s possible these invisible injuries will haunt some for the rest of their lives.

The Department of Defence revealed Thursday that a total of 64 US service members have been diagnosed with concussions, characterised as a mild traumatic brain injury, in the wake of the Iranian missile attack on US and coalition forces at two bases in Iraq earlier this month.

During the Iranian missile attack, US positions were rocked by the blasts from 1,000- to 2,000-pound munitions, Chairman of the Joint Chiefs of Staff Gen. Mark Milley said Thursday. “These things have bursting radiuses of 50 to 100 feet, and that’s just the shrapnel in the actual blast. These are very, very significant, serious weapons.”

Officers who survived the barrage described it as nothing short of a miracle there was no loss of life.

In this Monday, Jan. 13, 2020 photo, U.S. Soldiers stand near their residence area that was destroyed by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.AP Photo/Qassim Abdul-ZahraIn this Monday, Jan. 13, 2020 photo, U.S. Soldiers stand near their residence area that was destroyed by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.

‘A very serious and significant injury’

As for the injured, while the diagnosis is a mild TBI, “there’s nothing mild about a brain injury,” Michael Kaplen, a brain injury lawyer and a lecturer at The George Washington University Law School, told Insider.

“The term mild is really a misnomer when it comes to traumatic brain injury,” he explained. “It trivialises a very serious and significant injury.”

The common use of the word “mild” to characterise a TBI has its genesis in the Glasgow Coma Scale (GCS), a basic tool for emergency trauma care which ranks head injuries as mild, moderate, and severe. “It has become misused to characterise what a brain injury is in terms of its consequences,” Kaplen said.

Any brain injury can have certain troubling physical, cognitive, emotional and behavioural repercussions, some of which may last a lifetime.

Milley acknowledged this potential for affected service members, telling reporters: “We’ll continue to monitor them the rest of their lives and continue to provide whatever treatment is necessary.”

U.S. soldiers stand at the spot hit by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.AP Photo/Qassim Abdul-ZahraU.S. soldiers stand at the spot hit by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.

‘I can report that it’s not very serious’

In the short term, signs of a brain injury, which may appear immediately or possibly even days or weeks later, can be headaches, dizziness, nausea, balance problems, memory loss, sensitivity to light and sound and concentration problems. Some observers may fixate on these issues, and ignore the invisible neurological scars, problems that may persist for years.

“I heard that they had headaches and a couple of other things, but I would say and I can report that it’s not very serious,” Trump, who initially said that “no Americans were harmed” in the Iranian retaliation for a general’s killing, said once the number of injured service members had risen to 34.

“It’s deeply troubling when the president of the United States minimizes the seriousness of the injury,” Kaplen, who served as the president of the Brain Injury Association of New York State, said. “It does a significant disservice to members of the military with this condition.”

He described the president’s comments as “unfortunate,” “ignorant,” insulting,” and “disrespectful.”

U.S. soldiers stand at spot hit by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.AP Photo/Qassim Abdul-ZahraU.S. soldiers stand at spot hit by Iranian bombing at Ain al-Asad air base, in Anbar, Iraq.

Brain injuries can easily become chronic conditions that require long-term support for the affected individual, who may experience more severe control, language, concentration, memory, and behavioural problems as time goes on. And, because the injury is internal, it may be difficult for others to understand their struggles.

Depression can be a side effect of a brain injury, and, Kaplen explained, “people suffering the long-term consequences of a brain injury have much greater rates of suicide” – already a serious problem for US service members and veterans.

In instances where an individual suffers multiple traumatic brain injuries, they can develop chronic traumatic encephalopathy (CTE), a degenerative brain disease that can only be properly diagnosed during autopsy.

The US military puts battlefield injuries into one of three simple categories: very serious injuries (VSI), serious injuries (SI), and non-serious injuries (NSI), with more severe injuries being wounds like loss of limb.

The service members injured in the Jan. 8 attack “are in the NSI category at this time,” Milley said Thursday, adding that this might change. “We’re early in the stage of diagnosis,” he said. “We’re early in the stage of therapy for these troops.”

Thirty-nine service members have already returned to duty, the Department of Defence said Thursday. Eight have been evacuated to the US, and nine others are awaiting transport to the US. Others are still being assessed and treated in Iraq, Kuwait, and Germany.

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