A century after the first reported case of shell shock, an ailment that has afflicted soldiers since World War I, Johns Hopkins psychiatrist and neuropathologist Vassilis Koliatsos and colleagues have found what may be the distinct pattern in the brain associated with a blast injury. These hidden brain injuries may play a role in the psychological and social problems some veterans face after coming home.

 

Autopsies of combat veterans who survived improvised explosive devices (IEDs) and later died of other causes reveal a unique pattern of injuries in parts of the brain involved in decision making, memory, reasoning and other executive functions.

 

As shown in the images to the right, the honeycomb pattern of IED survivors’ brain injury (A) is very different from the effects of motor vehicle crashes (B) or opiate overdoses (C).