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This study presents self-reported traumatic brain injury (TBI) prevalence rates for 2,337 active duty U.S. Army soldiers who underwent baseline testing as part of a larger study of military TBI.A computerized self-report questionnaire was administered to a convenience sample of 2,337 highly functioning active-duty soldiers at Fort Bragg, North Carolina, who underwent baseline testing during a 13-month period in 1999 and 2000 as part of a larger ongoing Institutional Review Board-approved study examining the consequences of brain injuries among paratroopers.Approximately 23% of all of the soldiers surveyed reported sustaining a TBI after joining the Army. More than twice as many paratroopers reported sustaining TBI after joining the Army than did nonparatroopers (p0.001). Parachute-related TBI accounted for this difference. Nearly all of these injuries were mild. Less than 2% of paratroopers and no nonparatroopers reported loss of consciousness lasting more than 20 minutes. It was also shown that paratroopers with a history of TBI before joining the Army had a higher prevalence of TBI while serving in the Army (35%) than paratroopers without prior TBI (27.2%) (p = 0.002).This study demonstrates that parachuting appears to be a risk factor for mild TBI in the U.S. Army and that paratroopers with a history of TBI before joining the Army might be at somewhat increased risk of sustaining additional TBI while serving in the Army.

Routine surveillance of hospitals, emergency departments, and death certificates has resulted in reliable estimates of the incidence of moderate and severe traumatic brain injury (TBI) in the US population. TBI remains a common problem in the population and carries significant morbidity. However, despite increased consensus about the definition of mild TBI (mTBI), it is not possible to reliably estimate its incidence because a sizable minority of individuals with mTBI do not seek medical attention or are treated in outpatient settings not included in current surveillance programs. Although recently implemented TBI screening in the US military has identified mTBI cases that would have otherwise been undiagnosed, it would be difficult to screen the civilian population.

Objectives: To measure (1) the prevalence of postconcussive syndrome (PCS) symptoms associated with prior traumatic brain injury (TBI) and (2) their effects on the functioning of soldiers. Design: Population survey. Setting: Army paratrooper base. Participants: Convenience sample of 2055 soldiers. Interventions: Not applicable. Main Outcome Measures: Self-reported PCS symptoms and role functioning. Results: 947 soldiers reported prior TBI, nearly all of which was mild (loss of consciousness, ≤20min), and most of which (60%) occurred within the last 5 years. Soldiers with prior mild TBI reported more moderate to severe symptoms than soldiers denying prior TBI (mean symptoms, 4.2 vs 2.1), but fewer symptoms than soldiers reporting more severe TBI (mean symptoms, 5.4). Confirmatory factor analysis replicated the clusters of symptoms previously identified in a small, clinical sample by Cicerone and Kalmar (1995). Functioning correlated weakly with symptoms (with cognitive and affective symptom clusters: r range, .09–.19; P Conclusions: Even highly functioning individuals may have sequelae from prior TBI that can affect functioning.