The death of Matthew Livelsberger and blowing himself up on January 1st at a Trump Hotel in Las Vegas is unknown.
Aside from traumatic head injuries, Livelsberger may have experienced both post-traumatic stress disorder and trauma.
PTSD and TBI are not the same item. Several soldiers in war zones are affected by PTSD, which is also present in some residents. PTSD patients frequently go through “intense troubling thoughts and feelings” that may persist for a long time after their military services. They may experience grief, fear, or rage, as well as separation or estrangement from other people, according to the article. Suicide poses a serious hazard to those with PTSD.
Livelsberger’s ex-girlfriend, Alicia Arritt, reported that Livelsberger experienced problems, stress, memory loss and times of departure, which she identified as important indicators of TBI. Arritt had served at the German military base Landstuhl Regional Medical Center, where many men who had suffered battle wounds from Iraq and Afghanistan were treated, some of whom were still serving, as well as those from Syria and Iraq. Livelsberger, serving in Helmand territory in Afghanistan, told Arritt that he had suffered numerous injuries.
TBI is difficult to diagnose, hard to treat, and no usually mitigated by consultation. Livelsberger, a decorated Green Beret, deployed half to Afghanistan and served in Ukraine, Tajikistan, Georgia and Congo.
In brief, TBI is a hidden bodily injury. While it is possible to have both PTSD and TBI at once, it is even more difficult and challenging to cure severe cases of TBI.
In cases where there is an actual pain that is quickly apparent, treatments that are somewhat successful include diuretics to reduce the amount of liquid in brain tissue and increase urine output, anti-seizure drugs similar to those used for treating strokes, and coma-inducing drugs for cases where the brain is not getting enough blood due to pressed blood vessels coming from the concussive effects of a blast, according to I wrote in the Asia Times in January 2020.
TBI injuries are classified as mild, moderate and severe. Strong TBI is simple to spot because the victim will immediately become confused, may have blurred vision, or have trouble hearing, and may be confused or even incoherent. The symptoms may not appear for hours or even days after the injury occurred, and moderate and mild TBI are much more challenging to diagnose.
Most doctors in the military, as in medical diagnosis generally, use the , Glasgow Coma Scale , questionnaire to assess TBI. The , Glasgow Coma Scale , has three main components: it measures eye-opening and how the eyes respond to stimuli, a verbal response to questions ( for example, does the assessed victim cry or smile appropriately? ) and various checks for motor response.
TBI is generally recognized as the” signature injury” caused by improvised explosive devices ( IEDs ) and recently by missile, drone and rocket attacks on US bases in Jordan, Syria and Iraq. Since 2000, more than 500 000 service members have received TBI diagnoses. In 2024 alone, more than 20, 000 service members were diagnosed with traumatic brain injuries. According to the Defense Department, roughly 440, 000 service members are thought to be at high risk of being exposed to blasts due to their job types. Minor TBI is present in 15.2 % to 22.8 % of returning service members from operations in Afghanistan and Iraq.
Unfortunately, what might have been initially thought to be mild TBI can turn out to be much more severe brain trauma later. Moreover, multiple concussions compound the problem, since an initial test might only catch the first symptoms.
Just as in US sports, especially football, there is a real need to develop better helmets, face masks and other protections for servicemen and women. Face shields, for example,  , could help reduce the damage , a shock wave might cause to the brain, especially the frontal lobes. Face shields have not yet been adopted by the Army, despite the MIT study in 2010 that pointed the way.
More research has been done to improve the seating in military vehicles that is shock-resistant.
Blast shelters used on US bases, especially forward operating bases in combat zones, represent a significant shortcoming. Although blast shelters and warning systems are present in the Army, Marines, and other services, modern-generation shelters do not appear to deal with blast effects in a way that can protect against TBI. Many of those who had TBI-related injuries were inside shelters.
Given the high number of TBI cases and their long-term effects on society and health, a much higher priority needs to be given to TBI injuries. Better methods for identifying, classifying, and treating TBI cases anticipatibly could also help stop the blowback experienced by the victims and, in particular, by our communities in general.
Former US deputy undersecretary of defense for policy, Stephen Bryen. This article, which originally appeared on his Substack newsletter Weapons and Strategy, is republished with permission.