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Murine Model of Controlled Cortical Impact for the Induction of Traumatic Brain Injury
Published on: August 16, 2019
Pathology of head trauma
John M Hardman1, Anthony Manoukian
1Department of Pathology, John A. Burns School of Medicine, 1960 East-West Road, Honolulu, HI 96822, USA. hardman@hawaii.edu
Insights
Traumatic brain injury (TBI) encompasses primary and secondary injuries from various causes, with peak incidence in the young and elderly. Understanding focal and diffuse injuries is crucial for managing TBI patients.
Area of Science:
- Neurology
- Pathology
- Radiology
Background:
- Traumatic brain injury (TBI) is a significant cause of death and disability in the United States.
- Major causes include motor vehicle accidents, falls, assaults, and increasingly, gunshot wounds.
- Incidences peak in infants, children, and the elderly, with certain conditions increasing accident risk.
Purpose of the Study:
- To review primary and secondary injuries from TBI.
- To emphasize the importance of understanding TBI pathology for patient care.
- To highlight the role of imaging in diagnosing head trauma.
Main Methods:
- Review of clinicopathologic studies on head injuries.
- Assessment of incidence, severity, and etiology of TBI.
- Correlation of imaging findings (CT and MR) with pathologic abnormalities.
Main Results:
- TBI results in both focal lesions (e.g., contusions) and diffuse injuries.
- Gunshot wounds to the head are a growing cause of TBI mortality.
- Accurate interpretation of CT and MR images is vital for diagnosis.
Conclusions:
- Understanding the pathology of both primary and secondary TBI lesions is essential for effective patient management.
- Distinguishing between focal and diffuse injuries is critical for comprehending TBI morbidity and mortality.
- Radiologists and forensic pathologists play key roles in diagnosing and understanding TBI.
Abstract:
This article reviews the essential primary and secondary injuries attributable to traumatic brain injury (TBI) which causes one third of all injury deaths in the United States. Motor vehicle crashes, falls, assaults, guns, sports, and recreational activities are the major causes of TBI. Secondary peak incidences of TBI occur in infants and children and the elderly. Conditions that increase risk for accidents include alcoholism, prior head injury, prior meningitis, seizure disorders, mental retardation, and psychiatric disorders. However, gunshot wounds to the head are steadily increasing and since 1990 have caused more deaths each year than motor vehicle accidents. The incidence, severity, etiology, and specific types of injuries have been assessed in clinicopathologic studies of head injuries. The pathologic features of both the primary and secondary lesions attributed to TBI should be understood by anyone caring for head-injured patients. The computed tomography (CT) and magnetic resonance (MR) images mirror the pathologic abnormalities found in head trauma. Radiologists must accurately interpret the CT and MR images of injured patients. Forensic pathologists have long appreciated the characteristic focal lesions, such as coup and contracoup contusions, that occur in falls or vehicle accidents, but the understanding of diffuse injuries has been more elusive. Understanding the nature of the focal and diffuse injuries is critical to understanding the morbidity and mortality of brain injury.
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