Traumatic Brain Injury

Ashley Davidoff Md

The Common Vein Copyright 2010

Introduction

 leading cause of death in young adults and children.

igh incidence of BBB breakdown in patients with TBI a

BBB breakdown frequently follows head trauma and can last from several days to weeks

Onset of the early phase is rapid: the permeability of the BBB typically reaches a maximum within a few hours and subsequently declines. The onset of the second phase is delayed, starting from 3-7 days following injury, and probably constitutes part of the brain’s response to the injury.

 an be a direct result of the traumatic

impact injury endothelium of small blood vessels often incurs a concomitant shear injury

Other mechanisms, such as vasospasm

cerebral blood flow autoregulatory failure

regularities in nitric oxide secretion

coagulopathy

 

resultant ischemic state. BBB breakdown might also contribute to the extracellular accumulation of excitatory amino acids, which results in excitotoxicity

edema inflammation neuronal death  Several functional changes in astrocyte properties – glial scar formation seizures

References

Dan Shlosberg, MD, PhD; Mony Benifla, MD, MSc; Daniela Kaufer, PhD; Alon Friedman, MD, PhD

Blood-Brain Barrier Breakdown as a Therapeutic Target in Traumatic Brain Injury