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Updated: May 17, 2026
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System for Focal, Closed-System Central Nervous System Injury
Published on: November 29, 2024
Return to combat duty after concussive blast injury
Carrie H Kennedy1, J Porter Evans, Shawnna Chee
1Department of Behavioral Sciences, Marine Corps Embassy Security Group, Quantico, VA 22134, USA. carriehillkennedy@gmail.com
Summary
Combat zone concussion recovery is faster with fewer symptoms and no combat stress. Older age and combat stress symptoms were linked to delayed recovery in service members after blast injuries.
Area of Science:
- Military medicine
- Neurology
- Trauma care
Background:
- Limited data exist on acute concussion assessment and recovery in combat zones.
- Most research focuses on service members post-return, not during deployment.
Purpose of the Study:
- To examine acute concussion evaluation and recovery in service members evacuated from the battlefield.
- To identify factors influencing return to duty (RTD) and recovery from concussion in a combat zone.
Main Methods:
- Case series analysis of 377 service members evaluated for acute concussion.
- Comparison of service members who did and did not RTD/recover in the combat zone.
Main Results:
- Older age and combat stress symptoms were associated with failure to RTD/recover.
- Quicker recovery correlated with less severe headaches, fewer acute symptoms, and absence of combat stress reaction.
- Military Acute Concussion Evaluation (MACE) cognitive scores and loss of consciousness were not associated with RTD or recovery.
Conclusions:
- Combat stress significantly impacts concussion recovery timelines.
- Serial MACE evaluations may be clinically useful if administered within 6 hours of blast exposure.
- Findings inform battlefield concussion management and highlight areas for future research.
