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BrainSci. 2017,7, 11
respectively [2].Malesaged0–4yearshavethehighest rates forTBI-relatedemergencydepartment
visits, hospitalizationsanddeaths combined. Regarding themilitary,DepartmentofDefensedata
revealedthat from2000–2011,235,046servicemembers (4.2%of the5,603,720whoserved in theArmy,
AirForce,NavyandMarineCorps)werediagnosedwithaTBI [5]. Thus,TBIafflictsmillionsofpeople
eachyear, includingcivilianandmilitarypopulations. It ispertinent tonote that thesestatisticsdo
notaccount for thosepeoplesufferingfromconcussion/mildTBIwhodidnot receivemedical careor
hadoutpatient/office-basedvisits, estimatedbysometobehundredsof thousands, ifnotmillionsof
peopleeachyear [3].
1.2. ClassificationofTBI
TheseverityofTBIs is typicallycategorizedusingtheGlasgowComaScaleandcanrangefrom:
(a)mild; (b)moderate; to (c) severe [6]. TBIoutcomesareoftendeterminedbyusing theGlasgow
OutcomeScale,whichcategorizesgrossneurobehavioral rangesof recovery: (a)dead; (b)vegetative
state; (c) severedisability; (d)moderatedisability; (e) goodrecovery [7]. Analternativeprognosis,
usingRussell andSmith’s classification, is divided as severe or very severe [8]. Considering that
detailedclassificationhelps todetermine theseverityof injury, informstreatmentoptionsandisused
toassessprognosisandfunctional recovery, recentsuggestionshave indicatedthatbetterdiagnostic
andassessmentcriteriaareneededin theTBIfield[9,10].
1.3. TBIPrognosis
TheeffectsofTBIcanadverselyaffectqualityof life, includingcognitive,behavioral, emotional
and physical deficiencies. Any one ormore of these can negatively impact interpersonal, social
andoccupational functioning,aswellas families, communitiesandtheeconomyingeneral [11,12].
Impairmentofcognitivefunctioncanleadtodifficultieswithmemory,attention, learning,coordination
andsleepdisturbances [12]andcanpersist fordays,monthsorevenyears followingthe initial injury.
Other long-termdeficiencies include: languageandcommunicationproblems(19%),dysarthria (30%),
dysphagia (17%)[13],mooddisorders [14,15]andcognitive impairment,evensixmonthsaftermild
TBI [16].Anotherpost-traumatic syndromethatcanhavearelativelydelayedonset ispost-traumatic
epilepsy [14,15,17].Whileall epilepsiesareseizuredisorders,notall seizuresareepilepsy.Assuch,
the incidenceofearlypost-traumatic seizures (seizures immediately following,upto thefirst fewdays
after theTBI) ishigher than the incidenceofpost-traumatic epilepsy. Notably, about 25%ofbrain
contusionpatientsand32%–53%ofpatientswithpenetratingTBIdevelopdifferentdegreesofearly
post-traumatic seizures. Post-traumatic seizuresalsoseemtobemoreprevalent followingsevereTBIs,
althoughmildandmoderateTBIscanalsoresult inseizures [18]. Considering thenegative impact
of thesenumerousdisorders associatedwithpost-traumaticdeficiencies, aswell as the significant
numbersofpeople suffering fromthe chronic effects ofTBIs, researchefforts areunderway in the
hopesofbetterunderstandingthepathogenicprogression,anddevelopingsuccessful treatmentsof
anddiagnosticcriterionforTBI.
2.ABriefReviewofExperimentalTBIAnimalModels
InviewoftheheterogeneousclinicalnatureofTBI,numerousanimalmodelshavebeendeveloped
forexperimentation.Althoughlargeranimalsarecloser insizeandphysiologytohumans, rodents
areavaluableandcommonly-usedmodel inTBIresearch. Theirmodestcost,biological similarities,
moremanageablesizeandstandardizedoutcomemeasurementsarealladvantageous. Suchmodels
havebeenincorporatedforstudiesaimedat improvingourunderstandingof thedetrimental, complex
molecular cascades that are initiated by head trauma, aswell as the long-termneurological and
behavioral consequences. Therefore, unlessotherwise indicated, this reviewfocusesondata from
animalmodels (primarilyrodents)ofTBI.Amongthem,severalmodelsarewidelyusedinresearch:
fluidpercussion injury (FPI) [19–22], cortical impact injury (CCI) [23–25], penetratingballistic-like
brain injury[26],weightdrop/impactacceleration injury[27]andblastTBI injury[28,29].Although
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zurück zum
Buch Advances in Neuroimmunology"
Advances in Neuroimmunology
- Titel
- Advances in Neuroimmunology
- Autor
- Donna Gruol
- Herausgeber
- MDPI
- Ort
- Basel
- Datum
- 2017
- Sprache
- englisch
- Lizenz
- CC BY-NC-ND 4.0
- ISBN
- 978-3-03842-571-7
- Abmessungen
- 17.0 x 24.0 cm
- Seiten
- 164
- Schlagwörter
- neuroimmune, cytokine, chemokine, glia cel, neuron, neurodevelopment, neuroimmune disorder, neurologic disease, psychiatric disease, neuronal injury
- Kategorie
- Medizin