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Published: Aug 29, 2006 12:00 AM
Modified: Aug 29, 2006 06:48 AM

Brain injury budget faces cut

Military research, treatment at risk

Brain injuries are so common among U.S. troops that they're called the signature injury of the Iraq war, but Congress is poised to cut military spending on researching and treating them.

House and Senate versions of the defense appropriation bill would chop funding for the Defense and Veterans Brain Injury Center from $14 million to $7 million. The center runs 10 facilities across the country, including one at Fort Bragg that has performed research and treated soldiers' injuries since 1998.

"It's just ridiculous," said Sgt. Maj. Colin Rich, a Fort Bragg soldier who has been legally blind since he was shot in the head while serving in Afghanistan in 2002. "Whoever is cutting the budget must have a head injury themselves."

"With the bombs, the gunshot wounds and everything else, their plate is full," he said. "They need that money."

The Pentagon asked only for $7 million and didn't respond properly when congressional staffers tried to find out whether it needed more money for the program, said Jenny Manley, a spokeswoman for the Senate appropriations committee.

"The Pentagon needs to get behind the things that they want," she said. "Otherwise, we'd just be kind of guessing about what they really need."

Pentagon budget experts did not respond Monday to a request for information on why they had not sought more money.

It's not clear what the direct effects would be at Fort Bragg. A spokesman for the U.S. Army Medical and Research Materiel Command said no one with the brain injury center was allowed to comment on the budget.

George Zitnay, director of Laurel Highlands Neuro-Rehabilitation Center in Johnstown, Pa., who helped found the head injury center and acts as a consultant for it, said he is not sure how it would handle such a large cut. It might single out an entire program for slashing or spread the effect across several programs.

Doctors say the proportion of head injuries is higher in Iraq than in past wars partly because roadside bombs and suicide car bombs are often the weapons of choice for insurgents. Also, recent advances in body armor and helmets mean that troops caught in blasts often live but can be jolted so badly by the shock wave that their brains are injured by smacking against the inside of their skulls.

As of March 31, the Pentagon reported about 1,200 traumatic brain injuries as a result of the wars in Iraq and Afghanistan. Experts say the real total is much higher because closed-head injuries in particular -- those where there is no obvious wound -- often go undiagnosed.

The brain injury center's headquarters are at Walter Reed Medical Center in Washington. Its leaders had sought $19 million for the coming year, citing the growing number of patients, the cost of long-term care and the need for research to improve treatment and prevention.

Zitnay said that he and Dr. Andres M. Salazar, an Army neurologist, started the center in 1992 because of concerns about troops injured in Vietnam but never treated. Many ended up in mental hospitals or prison, and they suffered high divorce and suicide rates.

"It's one of those things that, people can't see it, they think there's nothing wrong," said Rich, speaking from Florida, where he was learning to work with a guide dog. "I know better."

His wound caused a host of ailments including loss of about half his vision, depression, mood swings and seizures. Without the center's help at Walter Reed and Fort Bragg, he couldn't imagine how he would have handled the problems.

"They have been the ones figuring out that, OK, you can go back to work in a day or two with some of these injuries, but the psychological and physical effects are going to come up down the road," Rich said.

Even in peacetime, Zitnay said, military personnel suffer about 11,000 head injuries a year. Such injuries are common at Fort Bragg, where paratroopers are frequently hurt in parachute jumps.

The center's branch at Fort Bragg is a key source of data for developing a model of normal brain function, a crucial tool for measuring the effectiveness of treatments.

Employees at the Bragg facility could not be interviewed for this story. But in an interview this spring for another story, E. Wayne Johnson, the program manager there, said it tests 200 to 300 healthy soldiers each month for such things as cognitive skill, reaction time, mood and military skills.

Its clinic, meanwhile, treats 30 to 60 soldiers a month, most with mild injuries.

The center's research at Bragg and elsewhere isn't just academic, Zitnay said. "It's developing new helmets, it's developing drugs we can use to treat memory loss, it's developing innovative rehabilitation strategies," he said.

The center's work, for example, can help battlefield commanders quickly determine whether a soldier who has received a blow to the head is fit for battle.

Zitnay testified before the Senate appropriations committee in May that the center needed $19 million this year, in part because of the number of head injuries from the wars. Thirty-three members of Congress signed the written request for that amount, he said.

The Pentagon's basic budget for the center -- $7 million this year -- has long been augmented by members of Congress with discretionary or "pork barrel" money. The Pentagon didn't request the discretionary funding this year, said Manley of the appropriations committee staff, and then didn't respond to a request about whether it actually needed more.

There is time, she said, and probably the will in Congress to add money to the budget if the Pentagon justifies it.

"I don't think it's a controversial program, and it's very legitimate and very deserving of funding."

Gabrielle Carruth, a member of the subcommittee staff who reports to U.S. Rep. John Murtha, a Pennsylvania Democrat, said that a group of Department of Defense, Walter Reed and head injury center officials planned to meet Monday to study whether to make a formal request for more money.

Zitnay said that given the nature of current fighting, the money is vital. Because brain injuries can require lifelong care, the need for money to treat the injuries doesn't stop when injured troops are discharged from the hospital.

"I can't put a Band-Aid on it and say, 'Here, you're well,' " Zitnay said.

Staff writer Jay Price can be reached at 829-4526 or jprice@newsobserver.com.

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