First physical evidence of blast wave injury found in an Australian soldier's brain
Warning: This story contains details of a suicide and may disturb some readers.
Around 450 serving soldiers and veterans have pledged their brains to the Australian Veterans Brain Bank following their deaths, hoping within them there will be microscopic evidence explaining the invisible damage caused by years of service.
Six donor brains have been received, with four now analysed.
Blast overpressure occurs when a weapon is fired and the explosion creates an invisible high pressure shock wave which travels through the body — including the brain, damaging the delicate brain tissue.
Repeated exposure can cause symptoms like memory loss, aggression, depression and suicidality but the damage often can't be seen on scans in living patients.
It's only after death when the brain is dissected that the unique pattern of scarring known as Interface Astroglial Scarring (or IAS) can be seen.
The first Australian donor with that distinct pattern of brain scarring was a veteran with repeated exposure to blasts "over a long period of time", said Australian Veterans Brain Brain Bank director Michael Buckland.
The brain scarring aligns with findings seen overseas.
"There is a disturbing association with problems with mental health and [symptoms mirroring] Post Traumatic Stress Disorder with this brain pathology," Dr Buckland said.
"Everyone I've spoken to in the neuropathology community understands that there is brain injury associated with blasts that needs to be actioned."
The Australian finding is significant according to former Australian Army Special Forces officer and veterans' advocate Paul Scanlan, who has been campaigning to expose the impact of repeated low-level blasts on Australian soldiers for years.
"I hope this helps it be recognised as an injury caused by service, opens up research and funding, and draws more attention to the plight of veterans here."
Scientists at the US Department of Defense Brain Bank first discovered the unique pattern of star-shaped scarring between the white and grey matter in the brain known as IAS in 2016.
Last year through interviews with dozens of military personnel, veterans and their families, New York Times reporter David Philipps pieced together what the US military had not: A group of elite Navy SEALs who died by suicide all had evidence of blast wave damage within their brains.
"Many of the SEALs who died knew that something was going wrong in their head before they died."
One of those that died went to great lengths to ensure the message got through. He wrote a suicide note describing his symptoms before killing himself in such a way as to preserve his brain, so it could be then analysed at a state-of-the-art Defense Department laboratory in Maryland.
"He set out a stack of books that he had read on concussion and other types of brain injuries and he hoped that would be his legacy," Mr Philipps said.
The determination to get their brains to the lab in the hours after their deaths was driven by the widows of the SEALs who suspected something was wrong with their husband's brains, Mr Philipps says.
"They were talking to each other. They had learned about this research and this brain lab that had just been set up, and they had really taken it upon themselves to make sure these brains got there — and also make sure that other widows knew about this — often in the hours after their husband's death," Mr Philipps said.
Despite all nine brains being analysed in a Defense Department lab, the information never made it back to the SEAL leadership, he said.
"There should have been a red flashing light saying 'warning, warning, everyone we've looked at has a brain injury'.
"But that just wasn't happening."
Dr Buckland from the Australian Veterans Brain Bank has travelled to the US to present his findings and meet scientists from the brain bank there.
"At this stage it is a numbers game. The more brains we're able to examine, the more clinical and medical histories we're able to analyse, the faster we're going to get answers," Dr Buckland said.
"There is now, at least within the NATO community, consensus that this is an issue and something needs to be done sooner rather than later.
"The first thing is trying to stop the injuries occurring in the first place — so regulating exposure, being able to accurately measure exposure — to try and minimise the risk."
Chief of Army Lieutenant General Simon Stuart told 7.30 he had been briefed on the AVBB's findings.
"We're also working with the US who have over, I think it's about 450 brains in their brain bank. So in terms of being able to draw conclusions from a larger data set, we're very interested in that as well," General Stuart said.
The Australian Army has been repeatedly criticised for failing to act swiftly on trials dating back over a decade that have repeatedly found Australian soldiers are at risk of brain injury from blast overpressure during training and combat.
General Stuart says he wants to see baseline cognitive testing of soldiers at enlistment and deployment — as well as monitoring and recording their exposure to blasts during training. Both measures which are not yet happening across the ADF.
"I'm really keen to make sure that we're doing everything we possibly can to prevent illness or injury wherever we can," Lieutenant General Stuart said.
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