Even in the early days of World War I, brain injury after being near an explosion was seen as a major cause of debilitation among soldiers. Concussions from the shock waves from bombs often killed soldiers without leaving a mark, thanks in part to the violent movement of the brain when the bombs detonated. Soldiers near detonations sought medical help after suffering from amnesia, headaches, and dizziness. This was the first time concussions were a focus of large scale medical research.
Concussions were initially known as shell shock in the first World War — the assumption was that all shell shock was the result of an injury. Army medics soon discovered that there was more than one cause for the symptoms. Similar symptoms were presented by soldiers near blasts without head wounds, soldiers with head wounds, and soldiers simply presenting psychologically. Doctors then realized that the phenomenon of shell shock was quite complicated.
10% of British battle casualties in WWI were some form of shell shock or neurasthenia; 1/7 of all discharges from the British Army were because of it. Huge numbers of apparently uninjured soldiers collected pensions and the British Army banned the diagnosis of shell shock to prevent losing more money to a syndrome they didn’t understand.
Post Concussion Syndrome
The injuries didn’t go away and, when the same symptoms began presenting themselves during World War II, the term post concussion syndrome was introduced to describe the psychological symptoms brought on after head injury. Diagnosis remained complicated. Linking of psychological symptoms to head injury was based often on closeness of time to injury. This lead to an attempt to divide casualties into whether the soldiers had a head injury or not — a distinction that was expensive and yielded no useful results.
Currently, concussions remain a serious source of injury for the armed forces around the world. Advances in science and developments in diagnosis procedures have helped. Much about brain trauma remains difficult to understand and researchers have been finding more and more reason to believe that severe, long-term damage comes from head injuries.