Dozens of US troops suffered traumatic brain injuries after Iran missile strikes

The Pentagon said Friday that 34 U.S. service members suffered traumatic brain injuries from Iran's retaliatory missile strikes earlier this month on Iraqi bases that house U.S. forces.

Half of the service members identified remained in Iraq and have returned to active duty, while the other 17 are under medical observation in Germany and the United States, chief Pentagon spokesman Jonathan Hoffman told reporters at the Pentagon.

Initially, President TrumpDonald John TrumpChasten Buttigieg: 'I've been dealing with the likes of Rush Limbaugh my entire life' Lawmakers paint different pictures of Trump's 'opportunity zone' program We must not turn our heads from the effects of traumatic brain injuries MORE said that no troops had been injured during the Jan. 8 attack. When reports of the head injuries surfaced, the president downplayed the severity of the trauma, referring to it as "headaches."

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This was the first updated injury report from the Iran missile strikes since the Pentagon announced on Jan. 17 that 11 American service members had been flown from Iraq with concussion-like symptoms.

As of Friday, eight service members who were previously taken to Germany have been taken to the United States where they will continue to receive treatment, either at Walter Reed National Military Medical Center or at their home bases. Those troops arrived back in the country earlier on Friday, Hoffman said.

Nine service members transported to Germany are still undergoing evaluation and treatment there, he added, while one service member who had been transported to Kuwait has received treatment and returned to duty in Iraq.

Hoffman said the eight service members brought to the United States do not necessarily have more severe injuries than the others, rather, they are receiving outpatient treatments and have the option to do so closer to home.

“I can’t speak to the individual’s medical, but I think in this case is if they’re receiving treatment they can either receive treatment in a hospital in Germany or they can return back to their home base to be with their families and to be back with their units and receive treatment in that environment,” he said.

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All 34 service members were found to have traumatic brain injuries (TBI) — which can range from a light concussion to a more severe injuries that include headaches, dizziness, sensitivity to light, restlessness and nausea  — that were diagnosed by a medical professional over the last several weeks.

“A lot of these symptoms, they are late developing, they manifest over a period of time, people, in some cases, their condition will improve and what we saw is a number of people who were initially screened for concussion-like symptoms ... saw their conditions improve rapidly and then others we saw their conditions didn’t improve. Some got worse and some had severe enough symptoms that they were transported on for further treatment,” Hoffman said.

Following the announcement of the 34 TBI cases, Senate Armed Services Committee ranking member Jack ReedJohn (Jack) Francis ReedLawmakers wary as US on cusp of initial deal with Taliban Pavlich: The Senate defends its integrity Five Senate Democrats make impeachment case in Spanish MORE (D-R.I.), called out Trump’s earlier comments as “an insult to our troops.”

“TBI is a serious matter. It is not a ‘headache,’ and it’s plain wrong for President Trump to diminish their wounds,” Reed said in a statement. “He may not have meant to disrespect them, but President Trump’s comments were an insult to our troops. He owes them an apology.”

Reed added that the U.S. military has used considerable resources to educate personnel about the signs and dangers of TBI, the need to take it seriously, and lift the stigma, and called on Trump to “quickly clarify his comments or they could cause further damage.” 

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Hoffman also said that Defense Secretary Mark EsperMark EsperDOD sued for alleged improper incineration of 'forever chemicals' More than 1,000 veterans speak out against Trump's 'sustained attacks' on Vindman The Hill's Morning Report - Democrats duke it out during Nevada debate MORE on Friday directed the Pentagon to review the process for tracking and reporting injuries.

“The goal is to be as transparent, accurate and to provide the American people and our service members with the best information about the tremendous sacrifices our warfighters make,” Hoffman said.

The U.S. military is already required to immediately report injuries that may threaten the life, limb or eyesight of a service member, but does not have the same requirement in the event of a possible TBI.

Hoffman said Esper’s direction is focused on the different types of reporting systems the U.S. military uses and “sometimes the administrative reporting of an injury is different than the medical reporting … we need to get that clarified.”

Despite the injuries, no one was killed in the Iraqi missile strikes. Iran's attack was a response to a U.S. air strike that killed Iran's top military commander, Gen. Qassem Soleimani, in Baghdad the week before.

No further military altercations between Iran and the U.S. have happened since, though Trump did announce a new wave of "punishing" sanctions against the country after the retaliatory strike.

Updated 5:31 p.m.