Iran War Renews Concerns About Lasting Toll of Traumatic Brain Injuries on US Troops
Nearly 700 U.S. service members have been wounded by drone and missile attacks on bases in the Middle East and other fighting during the Iran war, with most experiencing traumatic brain injuries (TBI) and returning to duty, according to public statements from military officials. The conflict, described as one without a clear end, has renewed concerns about the lasting toll of these invisible wounds on American troops.
The Pentagon’s chief spokesman, Sean Parnell, last month called the vast majority of injuries over a two-week period “minor concussions.” But military health experts and veterans warn that even seemingly mild blast exposures can lead to persistent neurological problems that may not surface for years.
A Signature Injury of Modern Warfare
Traumatic brain injury has been a “signature injury” in Afghanistan and Iraq, and the Iran war is proving no different. More than 500,000 service members were diagnosed with TBI between 2000 and 2025, with 82% of cases considered mild — though not all were combat-related, according to AP News.
Advocates say the injuries could still be undercounted because symptoms often overlap with post-traumatic stress disorder and other conditions. The military has made strides in screening and treating TBIs, but doctors still cannot predict who will suffer lasting problems.
“If you’ve seen one TBI, you’ve seen one TBI,” said Kelly Parker, director of independent services at the Wounded Warrior Project.
A New Type of Warfare
Troops face a new type of warfare with Iran in which drones may explode closer to their heads, as opposed to the ground-level roadside bombs and improvised explosives more common in the wars in Iraq and Afghanistan. The blast wave itself can be injurious even without a direct blow to the head.
“The blast wave itself can be injurious,” said Dr. James Kelly, an emeritus professor of neurology at the University of Colorado School of Medicine and chief medical scientist at the Invisible Wounds Foundation. “It’s a different cellular injury. Blast is a different thing than a blunt injury to the head.”
Concussions often are termed “mild” TBIs, and many people recover within weeks. But sometimes those with seemingly mild initial symptoms go on to have problems persisting for months or years, such as headaches, dizziness, or difficulties with memory or attention that’s sometimes called “brain fog.” Repeated blows are known to increase the chances of lasting problems, including chronic traumatic encephalopathy (CTE).
Congressional Scrutiny Over Care
Democratic lawmakers are calling for an investigation into the care that wounded troops received following an Iranian drone strike in Kuwait that killed six U.S. soldiers early in the war. Wisconsin Sen. Tammy Baldwin pressed the military on Wednesday to release the findings of its investigation into the March 1 attack at Port Shuaiba.
“I spoke directly with Wisconsinites who sustained traumatic brain injuries from (President Donald) Trump’s war in Iran and went weeks without so much as a screening, let alone specialized care, for their injuries,” Baldwin said in a statement.
According to CBS News, the Pentagon completed a monthslong review of the attack in July and briefed families of the fallen soldiers but did not assign blame. Wounded soldiers have accused military leaders of ignoring requests for additional medical supplies ahead of the attack and of downplaying their injuries in the aftermath. The Defense Department previously denied those claims.
Defense Health Agency spokesman Peter Graves said in an email that “it is policy that service members are screened for TBI.”
Veterans Describe the Long Road
For veterans of earlier conflicts, the consequences of TBI can persist for decades. Joe Shearer, a 40-year-old Marine veteran from Colorado Springs, Colorado, links two blast events during his 2005 Iraq deployment to traumatic brain injuries that were only recently diagnosed. He’s still plagued with symptoms ranging from dizziness and migraines to forgetting daily tasks and responsibilities to his wife and children.
“As long as you got back up and could go back on patrol, that’s kind of what you did,” Shearer said.
“You don’t want to be the guy who goes to sick call or says, ‘Oh, I’m hurt,’ because you’re away from your team,” he added. “There’s this culture of you don’t want to be seen as lesser or weak, so you hide injuries inherently.”
Army veteran Frank Sonntag, 75, of Queen Creek, Arizona, suffered a TBI from a mortar blast in Iraq in 2004. He didn’t seek treatment for two years, ignoring intensifying headaches and brain fog. It got to the point where it took 30 minutes to write an email, while colleagues told him he spoke one word every 10 seconds.
“Speech therapy was one of the greatest things I had,” Sonntag said. “They taught me how to practice the words I was speaking and how to put sentences together again.”
Spencer Milo, an Army veteran from Parker, Colorado, experienced his first TBI in Iraq in 2008 when his Humvee smashed into a wall to evade fire, and a second from a suicide bomber blast in Afghanistan in 2011. He said some people struggle to understand why he’s still dealing with migraines, seizures, and forgetfulness after so many years out of uniform.
“I’ve had fellow service members that were even with me on those days, and they’re like, ‘Dude, why can’t you just kick it?’” Milo said. “I really wish it was that simple. It’s tough because when you can’t see something, it’s hard to believe that it’s really there.”
The Brain Can Heal
Despite the grim outlook, experts emphasize that recovery is possible with proper screening, early treatment, and support.
“There’s still so much we don’t know about the brain, but one thing that we do know is it can heal itself,” Parker said. “We know that new neural pathways can be created, and we absolutely believe that the brain can adapt. We’ve seen it happen.”
Physical, speech, and art therapies can lead to improvements, she said. It’s imperative that people recover from a concussion before doing activities that put them at increased risk of another, said Dr. David Okonkwo, a University of Pittsburgh brain trauma specialist.
A War Without a Clear End
The Iran war, which began on February 28 when the U.S. and Israel launched attacks on targets across Iran, has already claimed the lives of at least 14 U.S. service members, with 624 troops wounded as of August, according to AP News. The conflict has devolved into a fight over the Strait of Hormuz, with diplomatic efforts ongoing but uncertain.
As the war continues without a clear resolution, the number of troops exposed to blast injuries will only grow. The long-term health consequences — for the troops themselves, for the healthcare system, and for veterans’ services — could persist for decades, as demonstrated by veterans from earlier conflicts.
The military has made progress in understanding and treating TBI since the wars in Iraq and Afghanistan, but the new dynamics of drone warfare present fresh challenges. The blast wave from a drone exploding near a soldier’s head is fundamentally different from a blunt-force injury, and the medical community is still learning how to identify and treat these injuries effectively.
For the nearly 700 troops already wounded in this conflict, and for the veterans of earlier wars who continue to live with the consequences, the full toll of traumatic brain injury is only beginning to be understood.
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