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A concussion is like an ankle sprain, said Warren Lux, a neurologist and acting director of the Defense and Veterans Brain Injury Center. “If you’re hurt, you’re not at 100 percent and you’re at risk for more injury,” he said.

The risk of concussion to U.S. troops in Iraq and Afghanistan is higher now than it has been in past wars, according to the center, mainly because of the prevalence of bomb blasts. That’s why the center is focusing on concussion and other forms of mild Traumatic Brain Injury to help figure out how to treat it and how long troops should wait before returning to hazardous duty. Right now, they know this for sure: “Brain injuries can affect your ability to make good decisions,” he said.

Just as it’s unreasonable to expect someone who just sprained an ankle to go for a run, it’s probably not the best idea for someone who experienced a concussion to immediately return to combat where quick cognitive processes and reflexes are needed, Lux said.

Concussion often results in a temporary loss of consciousness, confusion and memory loss. Most people recover from concussions within about a week, and anyone who is going to recover has usually done so within three months, said Lux.

But while brain function often returns to what it was before the injury, the brain itself might not fully heal. “Statistically there’s a higher rate of brain injury in people who’ve already had a brain injury than there is in the general population,” Lux said.

Some people engage in risky behaviors that raise the probability of injury, said Lux. Others might have delicate brains, or perhaps the brain becomes more susceptible to a second or third injury as a result of previous damage. What is known is that after multiple concussions, the chance of recovery goes down, and “multiple concussions can be more than additive,” Lux said. That means that multiple concussions can add up to severe, long-term impairment.

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