L16 - translational research in TBI Flashcards Preview

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Flashcards in L16 - translational research in TBI Deck (25):
1

_% of all TBIs are classified as severe

10%

2

The mortality rate after severe injuries is __%

35%

3

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

4

IN EXAM

what does the Glasgow Coma Scale assess?

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

5

TBI is a _______ condition

heterogenous

6

What is the current treatment steps

achieving medical stability- prevntion of crisis

stabilisation of intrcranial pressure

rection of swelling and bleeding

prevention of seizures

7

True or false

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

true

8

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

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

true

10

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

11

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

12

What are the chronic consequences of paed TBI?

increased risk of :

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

13

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

14

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

15

______ ____ 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

16

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

17

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

18

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

metabolism
neuroplasticity

19

true or false

survivors of childhood TBI are at increased risk of social dysfunction

true

20

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

21

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

22

TBI is not just a _____ ______ ____

single mechanical event

23

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

24

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

25

______ ____ mediates secondary damage after paed TBI

neutrophil elastase