The Pentagon confirmed that 19 American servicemen stationed in Iraq or Syria were diagnosed with traumatic head injury following last week’s rocket and drone attacks by militants backed by Iran.

According to a Pentagon spokesperson, Brig. Gen. Patrick Ryder. Ryder confirmed that two other servicemen at Al Tanf suffered minor injuries. POLITICO broke the story earlier Thursday.

The comments came a day after Defense Department reported that 21 servicemen had suffered minor injuries in the attacks of Oct. 17-18. The comments come a day after the Defense Department announced that 21 service members had received minor injuries during the attacks on Oct. 17 and 18.

Ryder reported that American troops were attacked by a mixture of rockets and one-way drones in Syria 12 times and in Iraq four times since October 17.

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Reports of brain injuries have highlighted the dangers facing hundreds of U.S. soldiers at bases in the Middle East. This threat will only grow as Israel prepares to invade Gaza on the ground. Another Iranian proxy released a statement on Tuesday threatening attacks against U.S. bases in Kuwait and the United Arab Emirates.

Defense Secretary Lloyd Austin has sent additional ships, aircraft, and air defenses into the region in order to protect American troops. This includes, most recently, multiple Patriot battalions, and a Terminal High Altitude Area Defense.

It is not the first instance that American soldiers have suffered brain injuries in the Middle East at the hands Iranian proxy forces. The Pentagon reported this spring that at least 23 military personnel had suffered brain injuries as a result of the March attacks on Syria, which killed an American contractor.

In 2020, Trump’s administration was criticized for initially denying troops were injured when Iran hit al Asad Air Base, Iraq, in January with more than 12 ballistic missiles. Then-President Donald Trump claimed that servicemen had complained of “headaches” at the time.

Later, the Pentagon confirmed that 109 soldiers had been diagnosed with traumatic brain injuries.

It is difficult to detect brain injuries, which are often reported many days after an incident. The symptoms can be anything from headaches to dizziness and blurred vision. They may also include confusion, ringing ears and confusion.