The Pentagon says at least more than a dozen Iranian rockets were fired at two targets in Iraq Tuesday that house U.S. troops. Damage assessments are ongoing.

President Trump said Wednesday that he didn’t consider the traumatic brain injuries reported by U.S. troops following an Iranian rocket attack to be serious.

On Friday, more than a week after Pentagon officials reported no injuries in a rocket attack on an Iraqi base housing U.S. troops, reports surfaced that 11 service members had been flown out of the country to treat persistent symptoms of traumatic brain injury. Tuesday, military officials acknowledged even more troops were being evaluated for injuries.

“I heard that they had headaches, and a couple of other things,” he told a reporter during a press conference at the World Economic Forum in Switzerland. “But I would say, and I can report, that it is not very serious.”

Officials clarified Friday that they were unaware of the concussions until Thursday evening, and that they would be updating reporting procedures for possible TBIs.

The Defense Department has been grappling with the issue of TBI throughout the Global War on Terror, as the sometimes invisible injury can be hard to detect, service members can be reluctant to report their suffering and the long-term damage can wreak havoc on mental and behavioral health.

Concussion, or mild traumatic brain injury, TBI, has been the most common serious injury to U.S. military personnel since 2000, with more than 408,000 cases diagnosed.

While most people who suffer concussion recover within seven to 10 days with appropriate treatment, severe or multiple concussions can have lingering and even lasting or progressive effects such as degeneration or brain changes that put aging veterans at risk for dementia, Alzheimer’s, Parkinson’s disease and other neurological conditions, according to researchers at the Department of Veterans Affairs Boston Healthcare System.

Mild TBI also is associated with mental health conditions such as post-traumatic stress disorder or depression: a study published last year in JAMA Psychiatry found that 21 percent of hospital patients diagnosed with a mild brain injury had PTSD or depression up to six months after an injury to their heads, compared with 12 percent of patients with an injury elsewhere on the body.

At their worst, multiple concussions have been linked to chronic traumatic encephalopathy, or CTE, the slowly progressive disease associated with athletes in high contact sports such as professional football and hockey players. Persons with CTE exhibit behavioral changes, memory loss and cognitive problems as they age.

“No, I don’t consider them very serious relative to other injuries I’ve seen,” Trump said, adding that he’s seen the aftermath of Iranian road side bombs, including “people with no legs and no arms.”

Trump’s comments only fed suspicions that the Pentagon is still not taking TBI seriously, though efforts have been underway to better study the issue, including the small jolts from regular weapons training that are also suspected of affecting long-term brain health.

“Just as you go into the doctor to get your cholesterol check, or for spot checks, we’re going to check your brain as well,” Jane Horton, a senior adviser to the defense undersecretary for personnel and readiness, told Military Times in December.

At times, Horton said, troops fall into the same assumptions about injuries that the president espoused Wednesday.

"Our service members see their friends that were next to them, to their right and to their left, who may have lost a limb or some other injury – and so they discredit, ‘Hey, I may have a head injury,’ " Horton said.

Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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