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Traumatic Brain Injury Center of Excellence

Welcome to the Traumatic Brain Injury Center of Excellence. Here, you'll find clinical tools for the assessment and management of TBI, provider training, patient resources, and research information.

Provider Resources Patient Resources Resources for Military Leaders Training and Events TBICoE Research TBI Numbers TBICoE Podcasts

NEW! Warfighter Brain Health Provider Toolkit App

Image promoting the new Warfighter Brain Health Provider Toolkit App. Image includes screenshots of the app itself stating it's now available at mobile.health.mil, highlighting the following features: a central location for provider resources; it automates the MACE 2; it is accessible offline; it's compatible with both Apple and Android devices.Designed for MHS providers, the Warfighter Brain Health Provider Toolkit app includes an automated MACE 2 and is a resource hub for several brain health topics. Resources come from TBICoE, DOD, VA, and the Joint Trauma System.

Learn more about the app, how to get it, and how to give your feedback with the WBH Toolkit QuickStart Guide and FAQ.

Thumbnail image of page 1 of the downloadable Warfighter Brain Health Provider Toolkit App QuickStart Guide and FAQ

Get the App

Mission and Vision

Mission: TBICoE unifies a system of TBI health care, reliably advancing the science for the warfighter and ready to meet future brain health challenges.

Vision: Principal organization to lead, translate, and advance brain health.

To accomplish the mission, TBICoE supports, trains and monitors service members, veterans, family members and providers who have been, or care for those who are affected by traumatic brain injury.

TBICoE works at the macro-level, screening and briefing service members heading into theater, performing pre-deployment provider training at military hospitals and clinics, gathering data mandated by Congress and DOD, and overseeing research programs. TBICoE develops educational materials for military and civilian providers, and for service members, veterans, and their families.

The DOD has further solidified TBICoE's role by naming it the Office of Responsibility for these tasks:

  • Creation and maintenance of a TBI surveillance database
  • Creation and distribution of the Family Caregiver Guide
  • Design and execution of a 15-year longitudinal study of the effects of TBI in Operations Enduring and Iraqi Freedom service members and their families

2023 TBICoE Annual Report

The TBICoE annual report provides an overview of accomplishments and activities from calendar year 2023.

Get to know TBICoE—meet some of the people and learn about their work. Download the report.

Cover design for the downloadable 2023 Traumatic Brain Injury Center of Excellence Annual Report 

TBI and the Military

Traumatic brain injury is a significant health issue which affects service members and veterans during times of both peace and war. The high rate of TBI and blast-related concussion events resulting from current combat operations directly impacts the health and safety of individual service members and subsequently the level of unit readiness and troop retention. The impacts of TBI are felt within each branch of the service.

Active duty and reserve service members are at increased risk for sustaining a TBI compared to their civilian peers. This is a result of several factors, including the specific demographics of the military; in general, young men between the ages of 18 to 24 are at greatest risk for TBI. Many operational and training activities, which are routine in the military, are physically demanding and even potentially dangerous. To get an idea of how many TBIs are sustained by each branch, each year since 2000 — check out the TBI DoD Worldwide Numbers page.

If you or a service member you care for is looking for more information about TBI, check out the Patient and Family Resources page — there you will find fact sheets, caregiver guides, and other patient resources. Review them with a medical provider as you work towards recovery or help the recovery process of a service member, veteran or family member.

Recent attention has been intensively focused on combat-related TBI, it should be noted that TBI is not uncommon even in garrison and can occur during usual daily activities. Service members enjoy exciting leisure activities: They ride motorcycles, climb mountains and parachute from planes for recreation. In addition, physical training is an integral part of the active duty service member's everyday life. These activities are expected for our service members and contribute to a positive quality of life; but these activities also can increase risk for TBI.

To learn more about how to protect yourself in non-combat daily life activities, check out our A Head for the Future initiative. You'll find TBI basics information, fact sheets to help guide you in protecting your head during sports and recreational activity, and read personal TBI recovery stories. 

Sign up for TBI Resources Update email for the latest in TBI information and resources for service members, veterans, and their caregivers and families.

Health care providers can make a significant difference in the life of someone with TBI by working to understand the strategies which are used to identify and treat a brain injury. Service members and veterans with TBI are a unique population because they may have experienced circumstances that further complicate their clinical picture. These circumstances include multiple deployments, prolonged periods of stress, chronic pain, and separation from family and friends.

Traumatic brain injury is a complex condition that can affect multiple aspects of physical, cognitive and behavioral functions. A wide range of medical specialties may be involved with the assessment, treatment, and rehabilitation of TBI patients, particularly in cases of severe TBI. These specialties can include, but are not limited to, audiology, ophthalmology, neurology, physical therapy, psychology, psychiatry, endocrinology, speech and language pathology and occupational therapy. Often, a multidisciplinary team is assembled to provide comprehensive care. In addition to specialty providers, primary care providers are integral in the identification and treatment of service members with TBI. Visit the Provider Resources and Provider Education pages for clinical recommendations, clinical support tools and provider education materials.

Sign up for our Providers' Brief email to get information on new and revised TBI clinical recommendations, educational tools, research trends, and other resources that help medical providers evaluate and treat those who have sustained a TBI.

Frequently Asked Questions

General Questions about TBICoE

The Traumatic Brain Injury Center of Excellence FAQs provides answers to questions we are regularly asked about the organization and its mission. 

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TBICoE is a congressionally mandated collaboration of the Departments of Defense and Veterans Affairs to promote state-of-the-science care from point-of-injury to reintegration for service members, veterans, and their families to prevent and mitigate consequences of mild to severe traumatic brain injury.

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The preferred name Traumatic Brain Injury Center of Excellence (TBICoE) aligns with the other centers of excellence within the Defense Health Agency’s Research and Development Directorate, under which the TBICoE operates. This name reflects the mission of the TBICoE, and will make for easy identification with internal and external stakeholders in identifying the organization and its mission.

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No. TBICoE will continue to oversee and conduct TBI clinically relevant research addressing gaps in TBI knowledge for our service members and veterans who have sustained a TBI. Additionally, TBICoE continues to provide training and materials to military medical personnel for diagnosis, prevention and treatment of TBIs. TBICoE develops, provides and distributes educational materials for both military and civilian providers, families, service members and veterans. Gathering and analyzing data mandated by Congress and the Department of Defense for reports will also continue.

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Our headquarters is located in the Washington, D.C. metro area. TBICoE supports a multi-center network of military treatment facilities and Department of Veterans Affairs medical centers nationwide and in Germany. At these facilities, network dissemination coordinators have resources and conduct education for medical providers, service members, veterans and their families. TBICoE conducts and supports traumatic brain injury clinical investigations at these collaborator facilities as part of the TBICoE research program.

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For providers, visit the Provider Resources section of the TBICoE webpages. There, medical personnel can find TBI clinical recommendations, support tools and education materials. Visit the TBICoE Research page and download the latest TBI Hot Topics Bulletin for the latest trends in TBI research.

The Patient and Family Resources section of TBICoE has fact sheets, patient guides for recovery, and family and caregiver guides.

TBICoE materials are available by download only. We will continue to develop and update TBI clinical and educational products, so bookmark the pages and check back often or sign up for the TBI Providers Brief or TBI Resources Updates email news to stay informed.

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Yes, TBICoE will continue its 28-year historical relationship with the VA. In fact, TBICoE has ongoing clinical research or educational activities that are coordinated through the VA and TBICoE.

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No, TBICoE does not provide medical care or referrals, but we do offer resources to help patients, their families and caregivers learn more about TBI together with their medical provider. Visit the Patient and Family Resources page to find fact sheets and other TBI patient and caregiver guides. TBICoE's outreach initiative, A Head for the Future is a resource to learn how to prevent, recognize and recover from a brain injury, and hear stories from TBI Champions.

A

If you have a question or concern about TBICoE or any of the products, please email us!

A

You can find support 24/7 through the websites and numbers listed below.

National Resource Directory

The national resource directory connects wounded warriors, service members, veterans and their families with services and resources at the national, state and local levels to support recovery, rehabilitation and community reintegration.

Military/Veterans Crisis Line

Dial 988, and press 1 or Text 838255

Crisis Line, text-messaging service, and online chat provide free, confidential support for all service members, including members of the National Guard and Reserve, and all veterans, even if they are not registered with VA or enrolled in VA health care.

Military OneSource

800-342-9647

Help for active duty military and their dependents, including 12 free non-medical counseling appointments.

VA's Polytrauma/TBI System of Care

VA's Polytrauma System of Care provides a full range of medical and rehabilitation services for all enrolled veterans and for service members covered by TRICARE authorization, who have sustained polytrauma, TBI or other acquired brain injury. Click on this link for admissions and referrals.

Department of Veterans Affairs Customer Service Hotlines

Health Care: 877-222-8387

Benefits: 800-827-1000

White House VA Hotline

Open 24-hours a day, 365 days a year

855-948-2311

VA's first non-clinical, non-emergency, around-the-clock call center. It provides Veterans a supplemental option to report issues if they are not being addressed through VA's normal customer service channels. Hotline agents answer inquiries, provide directory assistance, document concerns about VA care, benefits and services, and expedite the referral and resolution of those concerns.

Vet Centers

Vet Centers are community-based counseling centers that provide a wide range of social and psychological services, including professional readjustment counseling to eligible veterans, active duty service members, including National Guard and Reserve components, and their families. Readjustment counseling is free of charge and anonymous, and is offered to help make a successful transition from military to civilian life or after a traumatic event experienced in the military, including TBI. Does not require enrollment in VA health care.

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Report
May 3, 2024

2022 DOD Worldwide Numbers for TBI

.PDF | 1010.17 KB

TBICoE is the Defense Department’s office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you’ll find data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis in the calendar year 2022. The data is also broken down by each branch of the armed services.

Video
Mar 28, 2024

Headaches and TBI: A Journey of Treatment Over Time

Headaches and TBI: A Journey of Treatment Over Time

Dr. Joanne Gold, a pharmacist and neuroscience clinician with TBICoE, and experts from the National Museum of Health and Medicine discuss the treatment of headaches, past and present. Their conversation explores the museum's collections related to TBI and headache treatment, discusses ways to improve headache treatment, and highlights relevant TBICoE ...

Publication
Mar 28, 2024

TBICoE Research Review: Multiple TBI/Multiple Concussion

.PDF | 284.05 KB

Prior history of TBI may predispose an individual to increased risk of subsequent TBI, which may result from less force, and lengthier recovery from post-injury symptoms. Activities such as contact sports and military service carry particular risk for multiple TBI.

Fact Sheet
Mar 6, 2024

Managing Headaches Following Concussion Fact Sheet

.PDF | 592.42 KB

This patient fact sheet on managing headache following concussion will help patients understand post-traumatic headache basics, triggers, and non-drug remedies. Post-traumatic headache is one of the most common and persistent symptoms of mild traumatic brain injury.

Publication
Mar 5, 2024

Assessment and Management of Headache Following Concussion/ Mild TBI Clinical Recommendation

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This clinical recommendation, newly revised in 2024, includes specific recommendations of both pharmacologic and non-pharmacologic treatment of the most common types of post-traumatic headache, two additional PTH subtypes, and expanded information on medication overuse headache.

Last Updated: September 09, 2024
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