L16 - translational research in TBI

Question 1

_% of all TBIs are classified as severe

Answer 1

10%

Question 2

The mortality rate after severe injuries is __%

Answer 2

35%

Question 3

IN EXAM

What is the most common bedside scoring system to determine injury severity after TBI? Describe it.

Answer 3

Glasgow Coma Scale

it is a composition scale

higher the score = more mild

3 is the most severe = patient is not responsive

Question 4

IN EXAM

what does the Glasgow Coma Scale assess?

Answer 4

eye, vocal and locomotor responses, Loss of consciousness and post-traumatic amnesia

Question 5

TBI is a _______ condition

Answer 5

heterogenous

Question 6

What is the current treatment steps

Answer 6

achieving medical stability- prevntion of crisis

stabilisation of intrcranial pressure

rection of swelling and bleeding

prevention of seizures

Question 7

True or false

There are 1st and 2nd tier guidelines which are followed to treat severe TBI

Answer 7

true

Question 8

what is a decompressive craniectomy and is it good?

Answer 8

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

Question 9

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

Answer 9

true

Question 10

true or false

Females aged 0-4 have the highest rates of TBI related ED visits, hospitalisations and deaths combined

Answer 10

false

Males aged 0-4 have the highest rates of TBI related ED visits, hospitalisations and deaths combined

falls, motor vehicle, inflicted

Question 11

Why is younger brain TBI more detrimental?

Answer 11

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

Question 12

What are the chronic consequences of paed TBI?

Answer 12

increased risk of :

repeated TBI
chronic neurodegen diseases
post-traumatic epilepsy
psychiatric
social behaviour impairments

Question 13

What are the risks factors which influence outcomes after paed TBI?

Answer 13

pre-injury
- socioeconomic status
cognitive ability
age

Injury

• severity
• location
• mechanism/type

post-injury
-Family functioning
resources
peer social environment
co-morbidities

Question 14

true or false

severe TBI acquired early in life result in better outcomes compared to injuries sustained later in life

Answer 14

false

worse outcomes

contrary to belief that a younger brain was more resilient due to increased plasticity

Question 15

______ ____ can address the knowledge gap in the difference TBi has on young vs. old brain

Answer 15

animal models can address the knowledge gap in the difference TBi has on young vs. old brain

Question 16

at what age is a rodent a ‘‘child’’?

Answer 16

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

Question 17

What are the characteristics of the infant (p7), juvenile (p17-21*), adolescent (p35), adult (P60+) rodents?

• used in experiment examples of paed TBI

Answer 17

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

Question 18

adolescent (p35) have different injury responses in which two areas

Answer 18

metabolism

neuroplasticity

Question 19

true or false

survivors of childhood TBI are at increased risk of social dysfunction

Answer 19

true

Question 20

how is an increased risk of social dysfunction modelling in rodents?

Answer 20

3 chamber test - also in autism

paed TBI mice show social impairment at adulthood

Question 21

Comparable neuroanatomy between rodents and humans thought to mediate the ____ ____ ____

Answer 21

social brain network

need to further research how social outcomes are influences and can we improve them

Question 22

TBI is not just a _____ ______ ____

Answer 22

single mechanical event

Question 23

A young brain is less capable of defending itself against ___ from reduced antioxidant capacity post TBI

Answer 23

A young brain is less capable of defending itself against ROS from reduced antioxidant capacity post TBI

Question 24

Younger brains have an increase response to the pro-inflammatory cytokine ____ causing more _______ to inflame the brain

Answer 24

Younger brains have an increase response to the pro-inflammatory cytokine IL-1beta causing more neutrophils to inflame the brain

Question 25

______ ____ mediates secondary damage after paed TBI

Answer 25

neutrophil elastase