For many Americans, the injuries of war are the ones they can see. Burns, amputations, and shrapnel wounds often become the public image of combat. But one of the military’s most common injuries is almost invisible.
Since 2000, more than 505,000 traumatic brain injuries, known as TBIs, have been reported among U.S. service members. The number highlights a growing health crisis affecting troops in combat zones, training exercises, and military operations around the world.
A traumatic brain injury can happen after a blast from an explosion, a hard fall, or a sudden hit to the head. Sometimes the injury is obvious. Many times, it is not.
A service member may look completely healthy while still suffering damage to the brain.
Symptoms can include headaches, memory problems, dizziness, confusion, sleep issues, depression, anxiety, and trouble concentrating. In some cases, the effects can last for years.
One of the biggest problems is that many brain injuries are difficult to detect right away. Unlike broken bones or cuts, TBIs often leave no visible signs. Symptoms may appear slowly, or troops may ignore them because they want to continue their mission.
Modern warfare has also increased the risk. Explosions from roadside bombs, artillery, and heavy weapons create powerful shockwaves that can affect the brain even without direct contact.
Military doctors have struggled for years to diagnose TBIs in the field. Advanced medical equipment such as CT scans and MRIs are usually only available at hospitals far from combat zones. That means medics often have to rely on basic evaluations and self-reported symptoms.
Now, the Defense Health Agency is working on a new solution.
The military is developing the Traumatic Brain Injury Field Assessment Program, a system designed to help medics detect brain injuries much faster. The program uses portable technology and mobile testing tools that can evaluate a soldier’s brain function within minutes.
Jim Maguire, co-founder of GMS, says the challenge is creating tools that work reliably in the difficult conditions troops face in the field.
“The biggest challenges are the inherent complexity of TBI, ensuring tools remain accurate in high-stress and austere environments, accounting for confounding factors like fatigue or dehydration, and fielding systems that are rugged, affordable, and easy for medics to use,” Maguire said.
Still, he believes the technology could transform battlefield medicine.
“The opportunity is that standardized, deployable assessment tools could greatly reduce subjectivity, enable earlier and more accurate diagnosis at the point of injury, and improve triage decisions so injured personnel get timely care while uninjured personnel remain mission capable,” he said.
Military officials hope the technology will improve treatment, reduce unnecessary evacuations, and help injured troops get care sooner.
Experts say the need is urgent.
Undiagnosed brain injuries can affect judgment, reaction time, and decision-making during combat. Over time, untreated TBIs can also damage relationships, careers, and mental health long after military service ends.
Maguire says these new technologies could reshape military brain injury care over the next decade.
“Technologies like this could significantly improve how the DoD manages concussion and TBI by bringing more objective, high-fidelity assessment into the field, where traditional imaging is unavailable,” he said. “That would strengthen force readiness by reducing both false negatives, which leave injured warfighters in the fight, and false positives, which lead to unnecessary evacuation.”
He added that earlier diagnosis could also improve long-term health outcomes for veterans by reducing the risk of repeated neurological injury.
Veterans groups say traumatic brain injuries have become one of the defining health issues of the post-9/11 era.
For many service members, the hardest injuries to heal are the ones no one can see.
