Transient vestibular balance dysfunction after primary blast injury.

Area of Science:

• Military Medicine
• Traumatology
• Neurology

Background:

• Explosive munitions pose inherent risks to military personnel in active conflict zones.
• Primary blast injuries typically affect air-filled organs, unlike secondary or tertiary injuries.
• Protective measures against blast injuries are standard, yet risks persist.

Observation:

• A Marine exposed to the back-blast of a shoulder-launched multipurpose assault weapon at close range was studied.
• The Marine did not exhibit typical signs of severe primary blast injury despite the blast's intensity.
• Unique vestibular balance abnormalities were observed in the Marine post-exposure.

Findings:

• The case demonstrates that blast exposure can cause vestibular dysfunction without classic primary blast injury symptoms.
• Mild traumatic brain injury (mTBI) with vestibular manifestations may occur even with seemingly minor blast exposure.
• Recovery from these vestibular issues can be prolonged, impacting military duty.

Implications:

• Personnel with blast-induced mild traumatic brain injury and vestibular symptoms may require extended observation.
• Modified duty assignments might be necessary for military occupational specialties.
• This case underscores the importance of recognizing and managing subtle neurological and vestibular deficits in service members exposed to blasts.