Blast injuries are frequently sustained following direct exposure to either a high or low-order explosion emanating from a bomb or alternate source (e.g., gas tank explosion). Potential for chemical and/or radiologic contamination is high following a bombing. Therefore, quick response by knowledgeable and skilled professionals is essential in helping any surviving victims. Blast injuries commonly involve blunt trauma and penetrating injuries. Professional consensus suggests that there are 4 types of blast injuries: primary, secondary, tertiary, and quaternary. While primary injuries typically involve lung injury including pulmonary damage and air embolization, secondary injuries involve penetrating and blunt trauma which can lead to brain injury. Open and closed Traumatic Brain Injuries (TBI) are seen in the tertiary and quaternary type injuries.
Based on proximity to the blast, the severity of the survivor’s TBI can range from mild, moderate, to severe. Regardless of severity, potential for neurological consequences is heightened following a blast injury. Survivors generally suffer immediate injuries and can have problems involving confusion, disorientation, and/or headache. Cognitive dysfunction such as temporary loss of memory, problems with speech, etc. can occur immediately post-blast or even present months to years later. Neurological and neuropsychological assessment and monitoring remain essential tools that contribute to a clearer understanding of any structural and functional deficits due to brain injury.