Skip main navigation

Military Health System

Hurricane Milton & Hurricane Helene

Emergency procedures are in place in multiple states due to Hurricane Milton & Hurricane Helene. >>Learn More

Skip subpage navigation

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. 

A

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.

A

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.

A

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.

A

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.

A

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.

A

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.

A

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.

You also may be interested in...

Publication
Sep 29, 2023

Mild TBI and PTSD Clinical Pearls

.PDF | 924.82 KB

TBICoE's "Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Clinical Pearls," is a new supplemental product to the detailed research review. This resource is designed to be brief and provide key actionable “clinical pearls” that should be considered in the treatment of service members with comorbid mild TBI and PTSD.

Publication
Sep 29, 2023

TBICoE Research Review: Mild TBI and PTSD

.PDF | 435.28 KB

This research review provides an in-depth summary of the available clinical research on the topic of co-morbid mild traumatic brain injury and posttraumatic stress disorder. Specifically, this review will address symptoms, anatomy, diagnosis, and treatment of mild TBI, PTSD, and the unique circumstances associated with the presentation of both.

Video
Sep 21, 2023

TBI and Low-Level Blast Exposure: What Medical Providers Need to Know

TBI and Low-Level Blast Exposure: What Medical Providers Need to Know

This educational video, produced by the Traumatic Brain Injury Center of Excellence, focuses on the effects of low-level blast and traumatic brain injury. Its purpose is to provide supplemental information on low-level blast to health care providers and beneficiaries.

Technical Document
Jul 20, 2023

Infographic: What is the Acute Concussion Care Pathway?

.PDF | 714.95 KB

TBICoE developed this infographic as a quick reference tool that demonstrates application of the standardized acute concussion assessment and care process. By adhering to this established pathway of care for mild TBI, providers across the MHS can ensure a reduction in unwarranted variation and foster an integrated, standardized system of readiness and ...

Video
Jul 13, 2023

Acute Concussion Care Pathway Overview

What is the Acute Concussion Care Pathway thumbnail of educational video for providers.

The Acute Concussion Care Pathway standardizes acute concussion care in the Military Health System. This video is designed to educate medical providers on the ACC Pathway, improving their understanding and application of evidence-based clinical tools. This video covers aspects of the ACC Pathway in detail, providing explanations and guidance on using ...

Infographic
Jul 12, 2023

What is the Acute Concussion Care Pathway?

What is the Acute Concussion Care Pathway? The Acute Concussion Care Pathway is one of the DHA Director’s Quadruple Aim Performance Plan projects. The intent is to equip providers with state-of-the-science tools to standardize concussion assessment and care across the MHS. It is supported by the DHA Procedural Instruction 6490.04 which establishes the infrastructure to ensure patients achieve optimal concussion clinical outcomes.

TBICoE developed this infographic as a quick reference tool that demonstrates application of the standardized acute concussion assessment and care process. By adhering to this established pathway of care for mild TBI, providers across the MHS can ensure a reduction in unwarranted variation and foster an integrated, standardized system of readiness and ...

Report
Jul 7, 2023

2022 Defense Intrepid Network Annual Report

.PDF | 11.07 MB

The NICoE 2022 Annual Report showcases the collective achievements and impact of the Defense Intrepid Network for TBI and Brain Health. This was a phenomenal year of growth in traumatic brain injury (TBI) clinical care, research, and education. In the report, you will learn about the expanded clinical offerings, advanced understanding of TBI through ...

Publication
Jun 16, 2023

Neurodegenerative Diseases and Traumatic Brain Injury Information Paper

.PDF | 310.80 KB

The long term effects of TBI are unknown, but there is concern that there may be an association with neurodegenerative diseases years after the injury. The intention of this information paper is to summarize the available evidence for or against an association of TBI with three of the more common neurodegenerative diseases.

Fact Sheet
Jun 14, 2023

Leader Policy Guidance for Mild TBI/Concussion in the Deployed Setting Fact Sheet

.PDF | 723.27 KB

This document describes the line leader responsibilities for the Department of Defense mandated policy, DOD Instruction 6490.11, “DOD Policy Guidance for the Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting,” that applies to all service members involved in potentially concussive events in deployed settings.

Report
Jun 12, 2023

2021 DOD Worldwide Numbers for TBI

.PDF | 847.35 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 2021. The data is also broken down by each branch of the armed services.

Fact Sheet
May 22, 2023

Changes in Behavior, Personality or Mood Following Concussion/mTBI Fact Sheet

.PDF | 977.73 KB

This TBICoE fact sheet can be used by health care providers to educate patients with a concussion, or mild TBI, on how to manage changes in mood related to their injury. Patients and caregivers would also find this information useful.

Infographic
May 22, 2023

Dizziness and Visual Problems After Concussion

Graphic containing general information on dizziness and vision  problems after a traumatic brain injury. Visit health.mil/TBIFactSheets and download related fact sheets for information.

More than 80% of all concussions—also known as mild traumatic brain injury—in the military are considered mild. Dizziness and visual problems are among the most common symptoms after concussion and often resolve within days or weeks

Last Updated: September 09, 2024
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery