Literature Review On Traumatic Brain Injury (TBI)

LITERATURE REVIEW 2.1. INTRODUCTION Traumatic brain injury (TBI) is a common and potentially devastating clinical problem. Because prompt proper management of TBI sequelae can significantly alter the clinical course especially within 48 hour of the injury, neuro-imaging techniques have become an important part of the diagnostic work up of such patients, determining prognosis, and guiding rehabilitation.8 Traumatic Brain Injury (TBI) is a traumatically induced physiological disruption of brain function, as manifested by at least one of any period of loss of consciousness; any loss of memory for events immediately before or after the accident; any alteration in mental state at the time of the accident

This primary injury often initiates a cascade of secondary injury processes that evolve over the first few post injury days. 13 The secondary injuries can occur anytime after the impact and are potentially preventable.14 Prompt surgical intervention is necessary for good outcome. Computerized tomography (CT) scanning provides an objective assessment of the structural damage to the brain following traumatic brain injury.3 Acute CT is useful in identifying those individuals in whom deterioration is a result of a mass lesion and demonstrate extradural, subdural or intracranial haemorrhage, and midline shift, or traumatic subarachnoid haemorrhage and ventricular abnormality. The ease of access and speed of data acquisition ensures that, where appropriate, patients benefit from early surgical management which has been shown to improve outcome. 15 2.2 EPIDEMIOLOGY Traumatic brain injury (TBI) remains the leading cause of death and long-term disability in people younger than 40 years

Because many injury victims are young, more years of life are lost in males below the age of 65 from trauma than from cardiac and cerebrovascular disease, or from cancer, in the United States, Japan, and several European countries.14, 15 In the civilian population, the leading causes of TBI are falls (35.2%), motor vehicle crashes (17.3%), blunt impact (16.5%), and assaults (10%). Falls preferentially account for TBI at extremes of age, namely 65 years. Motor vehicle collisions (MVC) are the predominant cause of TBI in teens and young adults. Penetrating TBI is far less common than blunt (closed head) injury but is associated with worse prognosis.16 Traumatic brain injury (TBI) is a leading cause of death and disability among persons in the United States. Each year, an estimated 1.5 million Americans sustain a TBI. As a result of these injuries, 50,000 people die, 230,000 people are hospitalized and survive, and an estimated 80,000-90,000 people experience the onset of long-term disability.17 Population based studies in the United States suggested that incidence of traumatic brain injury is between 180-250/100,000 population per year.12 In Europe, from studies in six countries, an aggregate hospitalized plus fatal TBI incidence rate of about 235 per 100,000 was