FILE - In this Nov. 8, 2017 photo provided by the U.S. Department of Defense, German soldiers assigned to Surface Air and…
FILE - German soldiers fire the Patriot weapons system at the NATO Missile Firing Installation, in Chania, Greece, Nov. 8, 2017. The Pentagon says the U.S. aims to move a Patriot missile battery into the Middle East region to counter threats from Iran.

PENTAGON - U.S. efforts to better protect troops in Iraq from the threat of Iranian missiles are being held up by Iraqi officials, who have yet to decide whether to allow Patriot missile defense batteries into the country.

“We need the permission of the Iraqis,” U.S. Defense Secretary Mark Esper said Thursday, briefing reporters at the Pentagon.

Esper said disagreements about where to place the Patriot batteries also will need to be worked out, should Iraq give the United States the go-ahead.

Despite the complications, Esper and other top Pentagon officials are adamant that the missile defense system is needed after at least 64 U.S. troops suffered traumatic brain injuries from an Iranian missile attack on the al-Asad air base earlier in January. An earlier report said 50 American troops had been injured.

The figure includes another 14 cases reported since Tuesday.

Defense officials said late Thursday 39 of the affected troops have returned to duty in Iraq. Twenty-one troops have been transported to Germany for treatment and evaluation.

Another eight U.S. servicemembers have returned to the U.S.

FILE - Defense Secretary Mark Esper, left, standing with Joint Chiefs​ Chairman Gen. Mark Milley, right, speaks during a news conference at the Pentagon in Washington, Dec. 20, 2019.

“These were 1,000, 2,000-pound munitions that were coming in,” Gen. Mark Milley, the chairman of the Joints Chiefs of Staff, told reporters. “These are very, very serious, significant weapons.”

“If there was a Patriot battalion at al-Asad or Irbil or whatever, could they have shot down these TBMs [Theater Ballistic Missiles]? That’s what they’re designed to do,” he added.

Esper and Milley said the Pentagon is also taking a “hard look” at other ways it can bolster its defenses for troops in range of Iranian missiles.

But Milley said, for the most part, the existing defenses worked – intelligence allowed the U.S. to move its troops into secured bunkers before the missiles hit, preventing any loss of life or limb.

“That’s significant,” Milley said. “The [Iranian] intent was not only to destroy facilities and equipment but also to kill people.”

Initially, defense officials said no one was hurt when Iran launched at least 11 ballistic missiles at al-Asad Air Base in retaliation for the U.S. airstrike that killed Iranian Quds Force commander Qassem Soleimani in Iraq.

A week later, though, military officials reported almost a dozen troops had been treated for brain injuries. And the number has been rising steadily since.

Trump's remarks

U.S. President Donald Trump also sparked concerns when he seemingly dismissed the injuries as “headaches.”

“I don’t consider them very serious injuries relative to other injuries I have seen,” he said during a news conference in Davos, Switzerland, last week.

Pentagon officials defended Trump Thursday, explaining that the military does categorize the types of brain injuries diagnosed so far as “not serious.”

“I’ve had the chance to talk to the president. He is very concerned about the health and welfare of all of our service members, particularly those who were involved in the operations in Iraq,” Esper said. “He understands the nature of these injuries.”

In the meantime, military officials will be following up with all of the troops diagnosed with the brain injuries, even those who have been allowed to return to duty.

“We’re going to take care of them,” Milley said, noting there’s a chance complications could arise years from now. “We’ll continue to monitor them the rest of their lives.”