Blast physics and central nervous system injury

The effect of blast on biological tissue is well documented for particular organ systems such as the lung. This is not the case for the CNS, where the mechanism of CNS injury following a detonation and blast wave is unclear. The effect of blast on traumatic brain injury (TBI) has come into particular focus with the Global War on Terror and Operation Iraqi Freedom, and Operation Enduring Freedom where TBI has become known as the signature injury of these conflicts. The reason for the prominence of TBI in these particular conflicts as opposed to others is unclear, but may result from the increased survivability of blast due to improvements in body armor. In this review, we trace the historical context of blast injury and develop current concepts from this framework, in addition to highlighting many remaining unsolved questions.