The Molecular Pathophysiology of Concussive Brain Injury – an Update - 04/05/16

Doi : 10.1016/j.pmr.2016.01.003

Garni Barkhoudarian, MD ^a,^⁎ , David A. Hovda, PhD ^b,^c, Christopher C. Giza, MD ^d,^e
^a Pacific Pituitary Disorders Center, John Wayne Cancer Institute, Providence Saint John’s Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA
^b Interdepartmental Program for Neuroscience, Department of Neurosurgery, UCLA Brain Injury Research Center, Semel Institute, David Geffen School of Medicine at UCLA, Room 18-228A, 10833 Le Conte Boulevard, Los Angeles, CA 90095, USA
^c Interdepartmental Program for Neuroscience, Department of Medical and Molecular Pharmacology, UCLA Brain Injury Research Center, Semel Institute, David Geffen School of Medicine at UCLA, Room 18-228A, 10833 Le Conte Boulevard, Los Angeles, CA 90095, USA
^d Interdepartmental Programs for Neuroscience and Biomedical Engineering, Department of Neurosurgery, UCLA Brain Injury Research Center, Semel Institute, David Geffen School of Medicine at UCLA, Mattel Children’s Hospital - UCLA, Room 18-218B, 10833 Le Conte Boulevard, Los Angeles, CA 90095, USA
^e Interdepartmental Programs for Neuroscience and Biomedical Engineering, Division of Pediatric Neurology, Department of Pediatrics, UCLA Brain Injury Research Center, Semel Institute, David Geffen School of Medicine at UCLA, Mattel Children’s Hospital - UCLA, Room 18-218B, 10833 Le Conte Boulevard, Los Angeles, CA 90095, USA

^∗Corresponding author.

Riassunto

Concussion, or mild traumatic brain injury (TBI), affects millions of patients worldwide. Understanding the pathophysiology of TBI can help manage its repercussions. The brain is significantly altered immediately following mild TBI because of metabolic, hemodynamic, structural, and electrophysiologic changes. This process affects cognition and behavior and can leave the brain vulnerable for worse injury in the setting of repeat insult. This article is an update of our previously published review, reporting relevant and current studies from the bench to the bedside of mild TBI. Understanding the pathobiology can help prevent and treat mild TBI.

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Keywords : Concussion, Traumatic brain injury, Pathophysiology, Molecular mechanisms

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Key points

Introduction

Neurometabolic cascade of concussion

Glutamate release and ionic flux

Glucose metabolism and mitochondrial effects

Cerebral blood flow

Axonal injury and diffusion tensor imaging

Altered brain activation

Acute responses to repeat concussion

Potential for cumulative injury and chronic sequelae

Pituitary dysfunction

Summary

Disclosure: These authors have nothing to disclose.

Esportazione

Vol 27 - N° 2

P. 373-393 - Maggio 2016 Ritorno al numero

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Concussion in Sports
Scott R. Laker

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Sideline Management of Concussion
John Hyden, Benjamin Petty

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The Molecular Pathophysiology of Concussive Brain Injury – an Update - 04/05/16

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