Invisible Blast Brain Injuries Challenge Israeli Soldiers' Recovery and Daily Life
Thousands of Israeli Defense Forces soldiers exposed to intense explosions during prolonged combat face a common yet often overlooked injury known as blast traumatic brain injury (bTBI). Unlike other head injuries, bTBI results from extreme pressure changes during blasts and frequently leaves no visible damage on standard CT scans, making diagnosis difficult. Dr. Bela Melamed, head of occupational therapy at the "Turning Point" rehabilitation center in Shoham and a lecturer at Ariel University, explains that microscopic brain tissue damage causes persistent neurological and cognitive symptoms despite normal imaging results.
Affected soldiers struggle with everyday tasks such as preparing children for kindergarten, shopping, concentrating at work, and managing busy schedules. Symptoms include headaches, dizziness, sensitivity to light and noise, tinnitus, chronic fatigue, memory and concentration difficulties, slowed information processing, planning challenges, emotional changes like anxiety and anger, and sleep disturbances. These symptoms often emerge only after soldiers return home and attempt to resume normal life, as more severe physical injuries initially overshadow cognitive issues.
Dr. Melamed emphasizes the importance of specialized rehabilitation involving neurologists, occupational therapists, physiotherapists, speech therapists, and psychologists. Functional cognitive assessments help tailor treatment to improve daily functioning rather than just clinical test results. She shares cases of reservists who regained academic and parental abilities through personalized occupational therapy strategies.
Although bTBI is invisible on scans, its impact on quality of life can be profound. Early identification and comprehensive rehabilitation increase the chances of returning to studies, work, parenting, and independent living. "Our goal is not only to treat the injury but to restore people’s ability to live the lives they want," Melamed concludes.
