L16 - translational research in TBI Flashcards
_% of all TBIs are classified as severe
10%
The mortality rate after severe injuries is __%
35%
IN EXAM
What is the most common bedside scoring system to determine injury severity after TBI? Describe it.
Glasgow Coma Scale
it is a composition scale
higher the score = more mild
3 is the most severe = patient is not responsive
IN EXAM
what does the Glasgow Coma Scale assess?
eye, vocal and locomotor responses, Loss of consciousness and post-traumatic amnesia
TBI is a _______ condition
heterogenous
What is the current treatment steps
achieving medical stability- prevntion of crisis
stabilisation of intrcranial pressure
rection of swelling and bleeding
prevention of seizures
True or false
There are 1st and 2nd tier guidelines which are followed to treat severe TBI
true
what is a decompressive craniectomy and is it good?
allowing the brain to hemorage out - letting it swell
shown to be effective, but has worse long term outcomes
surgical process may have negative outcomes:infections
controversial but still used
could be more effective in children than adults
true or false
The immune response is very complicated and has different effects at different times of injury
There are a whole range of things used to control the inflammatory response
true
true or false
Females aged 0-4 have the highest rates of TBI related ED visits, hospitalisations and deaths combined
false
Males aged 0-4 have the highest rates of TBI related ED visits, hospitalisations and deaths combined
falls, motor vehicle, inflicted
Why is younger brain TBI more detrimental?
Skull structure - more protruded frontal lobe
Head-to-torso ratio
neck strength - muscles not as developed
brain water content - higher water, less myelination, more swelling
What are the chronic consequences of paed TBI?
increased risk of :
repeated TBI chronic neurodegen diseases post-traumatic epilepsy psychiatric social behaviour impairments
What are the risks factors which influence outcomes after paed TBI?
pre-injury
- socioeconomic status
cognitive ability
age
Injury
- severity
- location
- mechanism/type
post-injury -Family functioning resources peer social environment co-morbidities
true or false
severe TBI acquired early in life result in better outcomes compared to injuries sustained later in life
false
worse outcomes
contrary to belief that a younger brain was more resilient due to increased plasticity
______ ____ can address the knowledge gap in the difference TBi has on young vs. old brain
animal models can address the knowledge gap in the difference TBi has on young vs. old brain
at what age is a rodent a ‘‘child’’?
different measures (electrical activity and #synapses) point to different ages
need to look at the brain as a whole and match to rodent
1-4 years is the peak of synaptogenesis - good model for young TBI
What are the characteristics of the infant (p7), juvenile (p17-21*), adolescent (p35), adult (P60+) rodents?
- used in experiment examples of paed TBI
infant (p7) - peak brain growth spurt, oligodendrocyte maturation
juvenile (p17-21) - brain reaches 90% of adult size weight, peak in synaptic denisty and myelination
adolescent (p35) - sexual maturation, increased risk taking, ongoing frontal lobe refinement and white matter myelination
adult (P60+) - increased dementia risk
adolescent (p35) have different injury responses in which two areas
metabolism
neuroplasticity
true or false
survivors of childhood TBI are at increased risk of social dysfunction
true
how is an increased risk of social dysfunction modelling in rodents?
3 chamber test - also in autism
paed TBI mice show social impairment at adulthood
Comparable neuroanatomy between rodents and humans thought to mediate the ____ ____ ____
social brain network
need to further research how social outcomes are influences and can we improve them
TBI is not just a _____ ______ ____
single mechanical event
A young brain is less capable of defending itself against ___ from reduced antioxidant capacity post TBI
A young brain is less capable of defending itself against ROS from reduced antioxidant capacity post TBI
Younger brains have an increase response to the pro-inflammatory cytokine ____ causing more _______ to inflame the brain
Younger brains have an increase response to the pro-inflammatory cytokine IL-1beta causing more neutrophils to inflame the brain
______ ____ mediates secondary damage after paed TBI
neutrophil elastase
