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Long Term Consequences of TBIs
3.19.07
34
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Not Applicable
03/20/2007

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Term
What does TBI stand for?
Definition
Traumatic brain injury
Term
what molecular outcomes occur after a TBI that cause cellular loss and a change in outcome?
Definition
necrosis/apoptosis; inflammation; atrophy
Term
What are 4 observations that researchers are using to frame TBI research?
Definition
a. plasticity within the hippocampus
b. neural regeneration in the dentate gyrus
c. physiological consequences of synaptic reorganization
d. behavioral recovery
Term
Define a TBI
Definition
Craniocerebral trauma due to blunt or penetrating trauma to the head resulting in decreased level of consciousness, amnesia, intracranial lesions, death
Term
who is most at-risk for a TBI?
Definition
male young adults and elderly
Term
What does moderate disability mean according to the glascow outcome scale?
Definition
individual needs some physical/cognitive assistance but is capable of most activities and can be employed
Term
What is critical in order to improve outcome?
Definition
Initial resuscitation
Term
What can reduce secondary injury events that impair outcome
Definition
intracranial pressure monitoring (or specific measures like that)
Term
What happens to the skull with a large impact force
Definition
skull deforms only slightly before fracturing due to its inherent mechanical properties
Term
As the area that the force is applied to decreases, what happens to the impact of the force on the skull?
Definition
the facture tolerance decreases, and its nature changes from a linear to a penetrating or comminuted depressed fracture
Term
What do the majoriity of brain injuries caused by mechanical events cause?
Definition
injuries restricted to focal lesions such as surface cerebral contusions, intracerebral hematomas, subdural hematomoas, and epidural hematomas
Term
Why are epidural hematomas most likely to occure
Definition
They are most likely to occur when underlying dural vessels are torn as a result of a skull fracture--NOT BC of increased ICP.
Term
What 2 types of accelleration cause inertial forces causing brain lesions?
Definition
Translational and rotational
Term
What does translational acceleration produce?
Definition
ICP gradient and movement of the brain relative to the inner surface of the skull--the magnitude of which depends on the level of translational acceleration
Term
What does rotational acceleration produce?
Definition
widespread and significant tissue strains throughout the brain.
Term
With rotational acceleration, what is the amount of shear strain related to?
Definition
Both the amount of RA and the presence of Intracrainal dural compartments (falx, tentorium cerebri) and direction of motion
Term
What have the ICP changes and brain motions due to translational accelerations been linked to?
Definition
coup and cotrecoup contusions, intracerebral hematomas, subdural hematoma,
Term
What type of brain injuried does rotational accel cause?
Definition
Every single kind.
Term
How can neuronal survival and/or death be affected? (aka, how does inflammation affect this?)
Definition
In the acute posttraumatic period, the BBB is very leaky--so entry into the brain of circulating immunocompetent cells may influence neuronal survival/death.
Term
What is infiltration and accumulation of PMNs in parenchyma associated with?
Definition
the development of posttraumatic edema (and PMN depletion has been shown to improve outcome following brain injury in rats)
Term
What are the LTconsequences of pathological processes in the brain?
Definition
brain atrophy, cell death, and axons and dendrites are eliminated
Term
What are the most common long term impairments after TBI?
Definition
cognitive impairments (memory, emotion, executive performance)
Term
TBI is a risk factor for what diseases?
Definition
For epilepsy and for AD
Term
what is plasticity?
Definition
structural reorganization
Term
Can the adult mammalian hippocamups undergo plasticity?
Definition
yes
Term
Is plasticity considered adaptive or maladaptive?
Definition
Both: adaptive (learning/memory) and maladaptive (epilepsy)
Term
What are the LT features of TBI related to the hippocampus?
Definition
TBI deficits in learning and memory and prediliction for epilepsy are typical LT features
Term
Where has neurogenesis been demonstrated to occur?
Definition
In the adult mammilian hippocampus and olfactory region
Term
When does neurogenesis increase? when does neurogenesis decrease?
Definition
Increase: after experimental stroke or seizure and in response to an enriched environment and exercises. Stress reduces cell proliferation and is associated with memory impairment
Term
In animal models, what is the neurophysiological response of the CA1 region to a TBI?
Definition
CA1, recognized to play a role in learning/memory from LTP, becomes hypoexcitable, suggesting that new memories may be more difficult to establish.
Term
What does DAI stand for?
Definition
Diffuse Axonal Injury (Intertial loading)
Term
Does a focal or diffuse injury cause contusion?
Definition
Focal injury cause contusion
Term
Does a focal or diffuse injury cause DAI?
Definition
Diffuse injury
Term
Can contact loading cause a DAI?
Definition
Yes, but it also causes (and you should associate it with it causing) contusion/hemmorhage
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