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In this particular case, the force is coming against your chest so the blood gets squeezed. And as the blood gets squeezed, there's a lot of back apple blood into the brain. And because there's a pulse of over-pressure wave that happens (like this), the brain also swells (like this). And when the brain swells, it pushes against some of the fixed elements inside the skull.
And because of the way vasculature is organized in the brain, most of this damage happens in the front of the brain - what we call the frontal lobes. And that's very important because this is the site, the center, of the executive functions of the brain. Functions that allow you to put your life together, organize, plan ahead, understand abstract. And you can imagine this can make your life difficult.
When you look at a brain, you are looking at the life history of an individual who may have a history of blasts, fighting, substance abuse or all of those, if researchers could study survivors’ brains at different times after a blast — a week, a month, six months, one year, three years —that would be a significant step forward in figuring out what actually happens over time after a blast.
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