Traumatic Brain Injury (TBI)

Traumatic brain injury (TBI) is a common condition, constituting one of the leading causes of death in the pediatric population and young adults. It is a global health problem that produces motor disabilities, behavioral or cognitive sphere. These traumas are the leading cause of death in children over one year old and is also the cause of mental retardation, epilepsy and physical disabilities. It also represents one of the most frequent causes of death and disability in young people in our society. It requires immediate medical treatment and, sometimes, it requires surgical treatment. Approximately 50% of all deaths are associated with this trauma and this increases to 60% when it is for a vehicular accident.

Diagnosis, treatment and prognosis of these injuries has been modified in recent years based on the introduction of new techniques. The aim of urgent attention to TBI, regardless of severity, is to prevent secondary brain damage and identify intracranial abnormalities requiring emergency surgery. The pathophysiology of brain injury is classified into three types of injuries: primary, secondary and tertiary injury. The primary lesion is the direct damage caused by the impact of the trauma or the acceleration-deceleration mechanism, secondary develops as a consequence of the primary lesion, developing bleeding, edema, hyperemia, thrombosis and other secondary pathophysiologic processes and finally the tertiary injury is the late expression of progressive damage or caused by primary and secondary injury (causes neuronal death).

The pathophysiology of traumatic brain injury helps to have a better understanding of the different clinical manifestations of this type of trauma and its consequences in the short, medium and long term, in order to develop an appropriate therapeutic management of these patients. The diagnosis requires studies such as x-rays of the spine and skull, monitoring of intracranial pressure (ICP), computed tomography (CT), cerebral angiography, among other studies.

The general treatment for an injury in the brain skull can lead any of the following treatments: infusion of crystalloid solutions, maintaining a normal mean arterial pressure, apply pressure to sites of active bleeding, emergency surgery, if is necessary, reinforce cerebral perfusion and prevent secondary brain damage, among other treatments. To conclude, the medical care it is very important.

Bibliography:

Cruz Benítez, Luis and Francisco Javier Ramírez Amezcua. "Estrategias de diagnóstico y tratamiento para el manejo del traumatismo craneoencefálico en adultos." Trauma Vol. 10.No. 2 (2007): 46-57.

Guzmán, Francisco. "Fisiopatología del trauma craneoencefálico." Colombia Médica Vol. 39.No. 3 (2008): 78-84.

Ortega, Jorge Eduardo. ""Trauma Cráneo Encefálico: Actualización en el Manejo Médico"." Revista Medica Hondureña 66.4 (1998): 147-153.