In 2004, Curtis Armstrong was stationed in an Army watch tower in Iraq when the structure was hit by a mortar explosion.
Armstrong survived, but not without lasting effects. It took weeks for his hearing to return and disorientation to subside.
The blast caused permanent damage as well. By 2009, when he left the Army and enrolled in college, the 29-year-old central Ohio native -- who now lives in Michigan -- still hadn't fully recovered.
Today, he is plagued by anxiety, mood swings and memory lapses, and he struggles with language.
"I noticed it was hard to learn and retain new information, no matter how many notes I would write down," Armstrong said. "And unless it was life or death, I couldn't tell you what I did three days ago.
"That's when I started getting scared."
He was diagnosed with post-traumatic stress disorder early, but it wasn't until 2012 that doctors identified the true source of his troubles: traumatic brain injury.
Dr. Chrisanne Gordon is on the forefront of a new effort to spread awareness and improve treatment for the condition.
In 2011, she founded Resurrecting Lives, a Dublin-based nonprofit organization working to help victims get the help they need.
Unlike PTSD, traumatic brain injury is the result of an external force.
"A blast wave literally resounds through their brains," Gordon said. "A great force compresses and then expands their brains in a small period of time. That is what is causing nerve injury."
Blunt trauma also can result in TBI.
The condition is widespread and common among veterans returning from Iraq and Afghanistan. More than 450,000 Americans, many of them combat veterans, suffer from the condition. Ohio alone is home to an estimated 12,000 to 15,000 cases.
But the injury is tricky to pinpoint and often overlooked in favor of another diagnosis, Gordon said.
Sufferers in rural communities rarely have access to screening or treatment.
In addition to the symptoms Armstrong reports, victims of TBI suffer from chronic headaches and light sensitivity, and are at an increased risk for homelessness, depression and suicide.
Gordon, who works as a physical rehabilitation physician, was shocked to learn that routine screening for veterans only began in 2008.
Through Resurrecting Lives, she hopes to kick-start new research efforts after decades of inactivity.
She is working with local retired military personnel and the Ohio National Guard to improve and expand treatment options in Ohio, and has networked with groups engaged in similar efforts in 25 other states.
Her organization is helping to coordinate a landmark study of the brains of injured Iraq War veterans. This year, a planned pilot study will compare 25 Ohio veterans to their closest male relative who has not sustained a similar brain injury.
Neurological and physiological differences will help researchers map the effects of the injuries.
Gordon said it could act as a template for a larger study down the road.
"Studies like this one will change the way we're taking care of our returning military members, period," she said.
This spring, Gordon also plans to release a documentary film on the subject.
She has credentials outside of her medical practice: In 1999, she suffered a traumatic brain injury of her own when she fell and struck her head while putting up Christmas lights.
"I know the way out," she said. "Whether it's in the textbooks yet is immaterial. I know what works for people with actual brain injuries."
Armstrong is still in college. He is two credits away from receiving an associate degree in communications -- and said he feels optimistic about the future.
"It's going to be a struggle, but I do see that we're moving in the right direction," he said.
For more information, visit resurrectinglives.org.