Some of the brightest military minds are linking arms — and brains — with their civilian counterparts to improve injury outcomes for not only American service members but also for foreign troops fighting their own wars.
On the heels of an initial successful partnership producing new guidelines for penetrating brain injury treatment, the Military Traumatic Brain Injury Initiative (MTBI2) and the Brain Trauma Foundation (BTF) announced another project in 2024. This one will focus on improving traumatic brain injury (TBI) outcomes for patients around the globe.
“Two minds are better than one. No single person, team or organization will ever be able to singularly answer the most challenging questions surrounding TBIs,” said Army Lt. Col. Bradley Dengler, MTBI2’s director at the Uniformed Services University of the Health Sciences. “The collaboration between the Brain Trauma Foundation and the Military Traumatic Brain Injury Initiative unites world-renowned neurotrauma experts to develop innovative, evidence-based solutions for the most complex challenges in TBI care. By working together, we generate better solutions faster, which leads to improved outcomes for more TBI patients.”
One of those solutions is faster diagnosis of brain injuries and more aggressive treatment. Dr. Gregory Hawryluk, a Ukrainian American neurosurgeon and medical director of BTF, said it’s immensely helpful for doctors to “not be nihilistic” about TBI patients — even ones who appear too far gone in a war zone.
“People say, ‘Oh, this guy got shot in the head; let’s put him in a corner to die,’” said Hawryluk. “The problem is that that’s not well-established in the literature, and our experts say these patients can often do quite well if given the chance.”
That’s often because of neuroplasticity, or the brain’s ability to reorganize synaptic connections, including after dramatic battlefield wounds. Hawryluk compares it to his son practicing piano. The more he practices, the more his brain rewires itself. And even if injured patients are incapable of musical instruments, they are often still able to make amazing strides in recovery.
“That power for injured people to improve their own brain function is a big deal,” Hawryluk said.
The collaborating teams are in frequent contact with medical teams in Ukraine, who are using the guidelines in real-world combat situations and sharing their experiences in return. Besides technical knowledge, Hawryluk and his crew have also sent support through sushi deliveries to Ukrainian hospitals.
Back in the States, the first step in the new collaboration is a clinical trial evaluating the efficacy of lumbar spinal fluid drainage in severe TBI patients to reduce brain swelling. Brooke Army Medical Center will help supply patients beginning this summer. From there, they will develop further best-practice guidelines to be used in combat or austere environments.
“The guidelines establish a standard of care informed by the best available evidence and expert opinion to ensure that service members with TBIs receive the highest-quality treatment and experience the best possible outcomes,” Dengler said. “The guidelines serve as a comprehensive framework for delivering consistent and effective TBI patient care.”
Dengler and his colleagues are making a difference outside of Ukraine and the States, too. An Israeli neurosurgeon reached out to the BTF team before war broke out in Gaza, asking to use and study how the guidelines might work there. They printed pocket cards for dispersal to medical teams around Israel, with positive outcomes almost immediately.
“The first step in thawing an international relationship is getting the doctors to talk to each other,” Hawryluk said. “It’s been gratifying to see that we at BTF and MTBI2 can be a force for that good, even though we don’t want to be needed.”
