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Indian Journal of Neurotrauma 2006; 03(01): 9-17
DOI: 10.1016/S0973-0508(06)80004-3
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

A Clinician’s Guide to the Pathophysiology of Traumatic Brain Injury

Andranik Madikians
,
Christopher C Giza
*   Divisions of Critical Care & Neurosurgery and Pediatric Neurology, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
› Institutsangaben
Verantwortlicher Herausgeber dieser Rubrik:
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Publikationsdatum:
05. April 2017 (online)

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Abstract

Traumatic brain injury induces a complex pathophysiological cascade of cellular events. Central components of this response include increases in cerebral glucose uptake, reductions in cerebral blood flow, indiscriminate excitatory neurotransmitter release, ionic disequilibrium, and intracellular calcium accumulation. Acute glutamate release and nonspecific neuronal depolarization induce threatening perturbations in neuronal function. Restoration of homeostasis requires significant increases in glucose metabolism; however, there is often a concomitant reduction in cerebral blood flow, resulting in an uncoupling of supply and demand. Understanding the nature and timing of these processes provides the practicing clinician with a mechanistic rationale for acute physiological monitoring, aggressive interventions to address and minimize secondary injuries, implementation of advanced neuroimaging techniques, and careful monitoring return to normal activity in head injured patients.

Keywords

cerebral blood flow - glucose metabolism - glutamate - monitoring - positron emission tomography (pet)
 

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