“Breacher syndrome” is an unofficial term that describes the long-term effects of repetitive traumatic brain injuries (TBIs) in people who experience repeated exposure to blasts. Researchers are now learning more about its physical and psychological toll.

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Breachers are people trained to get into buildings using explosives. They usually work in the military or in law enforcement and can be exposed to many explosions throughout their careers. Researchers are currently trying to determine whether this exposure causes something informally termed “breacher syndrome.”

Breacher syndrome isn’t an official diagnosis but rather a guess at how exposure to many explosions may impact your brain over time.

At this time, there are only theories about how such exposure may affect you. But some studies suggest that encountering explosions often may affect how you think, feel, and function. Some researchers believe that the use of heavy weapons might also have an effect.

That’s because explosions may cause mild traumatic brain injury (mTBI), including concussions. In some cases, the repeated mild damage can build up over time. If the explosions are forceful enough, there’s uncertainty over whether they could cause more severe traumatic brain injury (TBI) or other complications later.

Who are breachers?

A small 2016 study defined breachers as “a unique population who, as part of their regular training, are exposed to series of controlled blasts under supervised conditions.” The supervised conditions are meant to minimize the risk of injury.

Breachers include law enforcement and military members who use explosions to get into buildings or fire heavy weapons.

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Many things can cause TBI, from a single knock to your head to a penetrating injury.

TBI isn’t specific to military or law enforcement members. About 1.7 million people in the United States suffer some form of brain injury each year. TBI effects can range from short-term symptoms to long-term effects and challenges.

TBI is more common in:

  • people between the ages of 15 and 19
  • people older than 65
  • military and law enforcement members exposed to explosions
  • some athletes in certain high impact sports

Researchers are trying to understand whether breachers’ chronic exposure to explosions can sustain these types of brain injury:

  • concussion or mTBI
  • post-concussion syndrome (PCS)
  • TBI
  • chronic traumatic encephalopathy (CTE)

There’s also ongoing research into the possible sub-concussive effects, which are brain impacts that may not qualify as concussions. Still, their effects can build up over time and cause more concerning complications.

Concussion-like symptoms and mTBI

Concussions are a type of mTBI. Most concussions aren’t dangerous, and symptoms resolve over time. But having several concussions over time may have a greater effect on your brain.

The Centers for Disease Control and Prevention (CDC) lists the following symptoms of a concussion:

  • headache or feeling of pressure in your head
  • nausea or vomiting
  • balance problems or dizziness
  • double or blurry vision
  • light or noise irritation
  • feeling sluggish, hazy, foggy, or groggy
  • confusion or problems with concentration or memory
  • not feeling right or feeling down

Department of Defense researchers conducted a meeting in 2018 to examine the effects of chronic low-level blasts on military members. The few studies available suggested that temporary changes could occur. They likened these changes to the effects of sleep deprivation or too much exercise.

However, a 2019 study suggested that repetitive exposure to low-level blasts might cause symptoms such as those in mTBIs.

A 2015 study looked at anecdotal evidence from 184 people, most of whom experienced occupational blasts. The study found that those who experienced more explosions had more symptoms. Their symptoms were also more severe.

A small 2016 study looked at repeated low-level blast exposure in a small sample of Marine Corps breacher instructors and students. The 2-week study found instructors had deficits in performing high-memory demand tasks. Memory problems are a symptom of concussions.

A 2017 review of 45 studies found that mTBI symptoms resolved within 3 months for half of the people in the studies. The other half demonstrated long-term cognitive impairment. But more research is needed in this area. The study didn’t specifically address mTBI caused by explosions.

Post-concussion syndrome (PCS)

A 10-year study found a 57% increase in PCS in military members exposed to low-level blasts.

PCS is a collection of several symptoms that occur after mTBI. People with more than one concussion are at increased risk.

Symptoms can be physical, cognitive, behavioral, or emotional and include:

  • fatigue
  • sleep disturbance
  • headache
  • dizziness
  • irritability
  • affective disturbance
  • apathy or personality changes that persist for 3 months or longer

Most symptoms go away in 7 to 10 days. If they last longer, see a healthcare professional.


There are fewer science-backed answers than questions about brain trauma in breachers. You may develop TBI depending on:

  • how severe an explosion is
  • the type of injury you sustain
  • the cumulative effect of repeated explosions

A 2020 study showed that the effects of exposure to repeated low-level blasts might show up in ways that aren’t easy to identify, even for military and law enforcement organizations with protocols in place.

The study, which included more than 100,000 people in occupations that exposed them to these blasts, found that the most consistent finding was tinnitus or ringing in the ears. Researchers hypothesized that effects are minor, accumulate over time, and are harder to identify without long-term follow-up.

Brain trauma also occurs differently in each person.

According to the Brain Injury Association of America (BIAA):

  • No two brain injuries are the same.
  • The effects of a brain injury are complex and vary from person to person.
  • The results of a brain injury depend on factors such as cause, location, and severity.
  • A brain injury can change how you act, think, and feel.

Discuss your history with a healthcare professional if you think you may have experienced a brain injury. They can help you identify and keep track of any symptoms you may have and order tests if needed.

Chronic traumatic encephalopathy (CTE)

Repeated head traumas over many years can cause CTE. It’s usually linked with competitive athletes such as professional football players. But it can also affect soldiers and law enforcement officers.

There’s not enough research into a possible link between CTE and chronic exposure to explosions. But as many as 17% of people with repetitive concussions may go on to develop CTE.

“Multiple exposures to explosions could cause CTE, but how many and how severe, to my knowledge, has yet to be worked out,” BIAA National Medical Director Dr. Brent Masel explained. “There may be some research on mice and rats, but that only poorly correlates to what happens to humans in an explosion where there is flying debris and the human may be thrown into the air.”

Symptoms of CTE can develop slowly over time and include:

  • short-term memory loss
  • headaches
  • mood changes
  • erratic behavior, including aggression, depression, and suicidal thinking
  • increased confusion and disorientation
  • problems sustaining attention
  • brain fog
  • slurred speech
  • significant memory problems
  • tremor
  • slow movement

Post-traumatic stress disorder (PTSD) is a condition some people develop after exposure to severe stress or trauma such as:

  • military combat
  • sexual or physical assault
  • severe injury
  • witnessing violence and death

You may be at higher risk of PTSD if you have served in the military or law enforcement. TBI can also increase your risk, although it’s unclear how much.

A 2021 study of 34 career breachers, for instance, found that the breachers had higher scores on a PTSD scale, although they didn’t meet the clinical definition for PTSD.

Another 10-year study also found a relationship between TBI and PTSD but didn’t specify how much it increased risk.

Some PTSD symptoms to be aware of are:

  • intrusive thoughts about the traumatic event
  • negative mood changes
  • being easily startled
  • feeling overwhelming guilt or shame
  • feeling disinterested in your relationships, career, or hobbies
  • flashbacks
  • nightmares
  • feeling emotionally distressed when something reminds you of the event
  • struggling to concentrate, sleep, or eat
  • self-destructive behavior, including substance use
  • self-harm
  • suicidal thoughts
  • panic attacks
  • negative beliefs or expectations about yourself, others, or the world
When to get help

Consider seeing a healthcare professional immediately if you develop any symptoms of the conditions that may be associated with breacher syndrome. Early detection and treatment of the underlying cause can help you feel better sooner and help prevent further complications.

There’s ongoing debate as to whether TBI can increase your risk of neurodegenerative diseases such as:

A large 2018 review of studies that looked at more than 3 million cases found no link between TBI and neurodegenerative diseases.

Still, there’s a wealth of research to suggest a link.

According to a 2019 review, TBI can cause brain atrophy, a loss of brain matter. This can eventually lead to dementia. The researchers recommended that doctors use brain imaging, such as MRI and positron emission tomography (PET) scans, to find and track these changes.

A 2021 study also looked at brain changes. Researchers found that long-term changes in the brain from mTBI and TBI resemble brain changes due to Alzheimer’s disease.

A 2018 Swedish study found that multiple TBIs increased the risk of dementia. It also found that this risk persisted for more than 30 years after the trauma.

A 2016 study found that people with a history of TBI experienced mild cognitive impairment 2 or more years earlier than people without a history.

CTE also has a significant effect on your brain. According to the Alzheimer’s Association, over time, CTE may lead to Parkinson’s-like symptoms and dementia.

But does all this apply to breachers?

Army-funded research from 2021 showed that blasts affected neurons in the brain and may increase the risk of Alzheimer’s disease. It also found that brain changes were present, even if symptoms of TBI weren’t. But as Masel cautions, this is a study with rats and may not necessarily translate to the human experience.

A 2017 review, however, specifically mentions blasts as a risk factor for TBI-related dementia. And two studies (1, 2) from 2015 found long-term brain changes in military veterans exposed to blasts, even if they didn’t have acute TBI symptoms.

So, while more research is needed, there’s evidence to support that this may be a concern for breachers.

There isn’t guidance specific to breacher syndrome yet because much more research is still needed.

However, a small 2018 study suggested the following for healthcare professionals helping people who have experienced mTBI:

  • Educate and reassure the person.
  • Don’t be generic. Tailor information to the person.
  • Get a feel for what information the person has read and understands about the injury.
  • Help the person make sense of data from multiple sources.

The National Institutes of Health recommends the following to help you recover from the effects of TBI:

  • Psychological counseling: Counseling can help you improve your coping and social skills.
  • Cognitive therapy: This may help with skills related to memory, attention, learning, and decision making.
  • Medication: Some medications may help resolve chemical imbalances in your brain because of TBI.

See a healthcare professional as soon as possible to address your symptoms and treat any potential long-term effects.

Support for breachers

There isn’t a go-to source for breacher support. However, the BIAA has an extensive listing of educational articles for those affected by a brain injury and their caregivers. Its website also has a tool to help you find your closest BIAA support office.

You can also reach BIAA by phone at 800-444-6443.

Military.com also has a listing of TBI resources.

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Some studies have called for further research and updated safety and training protocols for military members and others likely to be exposed to low-level blasts.

Many studies have also called for improved medical care and the detection of long-term damage.

Early detection and follow-up care are crucial for getting the proper treatment for any effects you may be experiencing.

There’s a need for awareness of how job-related explosions impact breachers and more ways to detect when someone experiences any form of brain trauma related to explosions. Blasts vary by intensity, duration, and number, all of which change the impact on your brain.

Researchers hope an exploratory study in a small sample of military special operations forces with repeated blast exposure will help answer some of those questions.

Many short-term symptoms of concussions and PCS resolve without treatment in a few days or weeks. If they last longer, it’s best to see a healthcare professional who can diagnose and treat any lingering effects.

Breacher syndrome isn’t an official diagnosis but refers to many possible effects of job exposure to low-level blasts and heavy weapons fire.

This exposure can have mild, moderate, or potentially severe effects depending on the force of the explosions, your exposure to them, and how long they lasted.

Many effects are similar to, or a bit milder than, a concussion. But many small exposures can add up over time.

Depending on your injury, you may be at greater risk of TBI, CTE, or PTSD.

In many but not all cases, symptoms resolve within a relatively short time.

See a healthcare professional as soon as possible if you have any symptoms of breacher syndrome. It’s important to look for good long-term care because it may take a long time before the effects build up enough to cause significant symptoms.

Family members can help by looking for changes in a person’s personality, habits, and moods or symptoms of associated conditions.