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Thara Tunthanathip, Kanutpon Khocharoen, and Nakornchai Phuenpathom

military convoys, attacks with mines, and IEDs concealed in motorcycles. These handmade weapons cause unique patterns of injuries, especially brain injuries. 4 FIG. 1. Map showing the southern conflict region, composed of three southern border provinces ( gray ) and four districts of the Songkhla province. The general mechanisms of blast-induced traumatic brain injury (bTBI) are an explosion that generates immediate blast energy and a wave that impacts the head, resulting in a primary blast injury. Secondary blast injuries are found in victims who are further away from

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Albert Català-Temprano, Gemma Claret Teruel, Francisco José Cambra Lasaosa, Martí Pons Ódena, Antoni Noguera Julián, and Antonio Palomeque Rico

than 40 mm Hg; however, values greater than 70 mm Hg do not offer any advantage. The treatment of children with TBIs must include ICP control measures and the attainment of an optimal CPP level. References 1 Bouma GJ , Muizelaar JP , Choi SC , Newlon PG , Young HF : Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemia . J Neurosurg 75 : 685 – 693 , 1991 2 Bullock R , Chesnut RM , Clifton G , Ghajar J , Marion DW , Narayan RK , : Guidelines for the management of severe

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Haydn Hoffman, Taylor Furst, Muhammad S. Jalal, and Lawrence S. Chin

T here are more than 1 million new cases of traumatic brain injury (TBI) each year in the US. 18 TBI accounts for over 50,000 deaths annually 4 and is the leading cause of disability in young adults, 10 generating a major national socioeconomic burden. Recent data suggest that emergency department visits and hospital admissions for TBI are increasing. 14 TBI can be classified as mild, moderate, or severe based on the patient’s presenting Glasgow Coma Scale (GCS) score. Neurosurgical intervention is indicated for the management of refractory elevated

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Halinder S. Mangat, Xian Wu, Linda M. Gerber, Hamisi K. Shabani, Albert Lazaro, Andreas Leidinger, Maria M. Santos, Paul H. McClelland, Hanna Schenck, Pascal Joackim, Japhet G. Ngerageza, Franziska Schmidt, Philip E. Stieg, and Roger Hartl

D eaths from injuries and violence account for 9% of global mortality and disproportionately affect young males. 1 Among patients who sustain trauma, traumatic brain injuries (TBIs) contribute to 30% of all deaths. 2 While in high-income countries (HICs) neurotrauma incidence and mortality are decreasing, the incidence in middle-income countries (MICs) and prevalence in low- and middle-income countries (LMICs) are increasing, and data on mortality are sparse. 3 , 4 Rapid urbanization in low-income countries (LICs) and LMICs has led to an unprecedented growth

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Asim Mahmood, Dunyue Lu, Yi Li, Jae Li Chen, and Michael Chopp

secondary deleterious effects of BM transplantation, such as induction of tumors or the immune response observed with graft rejection. The brain is considered to be immunologically privileged and an area less susceptible to an attack from the immune system. 24 Traumatic brain injury elicits an inflammatory response; 14 however, BM transplantation did not appear to augment this response. This is a preliminary study in which we examined the possibility of using BM transplantation as a means of improving outcome after TBI; a number of studies remain to be performed. We

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Michael F. Stiefel, Yoshiyuki Tomita, and Anthony Marmarou

± 11 168 ± 14 4.25 ± 2.75 3 140 ± 15 63 ± 33 143 ± 17 4.20 ± 1.64 4 147 ± 15 42 ± 12 — — * Values are presented as the means ± SDs. — = the [Na + ] e level could not be calculated; it was never restored postinjury. Traumatic Brain Injury Physiological Parameters Baseline MABP was 111 ± 1 mm Hg and exhibited a significant elevation to 124 ± 4 mm Hg (p < 0.05) during the first 30 minutes after TBI ( Fig. 3 ). Intracranial pressure was also significantly elevated (mean 15 ± 2 mm Hg) for 30 minutes

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Ethan A. Winkler, John K. Yue, John F. Burke, Andrew K. Chan, Sanjay S. Dhall, Mitchel S. Berger, Geoffrey T. Manley, and Phiroz E. Tarapore

T raumatic brain injury (TBI) is an alteration in brain function or other evidence of brain abnormality, resulting from an external force applied to the head. Traumatic brain injury occurs in several settings common to daily life, including recreational activities. 21 , 25 , 30 In the United States, more than 2.5 million people seek medical care for TBI annually. 13 Underreporting of sports-related injuries, lack of consensus definitions, or limited recognition of milder injuries likely leads to gross underestimation of the true incidence of TBI. 36

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Asim Mahmood, Dunyue Lu, Changsheng Qu, Anton Goussev, and Michael Chopp

Neurol 130 : 173 – 177 , 1994 6 Dixon CE , Clifton GL , Lighthall JW , Yaghmai AA , Hayes RL : A controlled cortical impact model of traumatic brain injury in the rat . J Neurosci Methods 39 : 253 – 262 , 1991 7 Dixon CE , Flinn P , Bao J , Veyna R , Hayes RL : Nerve growth factor attenuates cholinergic deficits following traumatic brain injury in rats . Exp Neurol 146 : 479 – 490 , 1997 8 Hicks RR , Boggs A , Leider D , Kraemer P , Brown R , Scheff SW , : Effects of exercise following lateral fluid

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R. Mark Richardson, Amanpreet Singh, Dong Sun, Helen L. Fillmore, Dalton W. Dietrich III, and M. Ross Bullock

in the extracellular matrix, and altered trophic factor expression. It is possible that while some of these mechanisms attenuate acute damage at the expense of future regenerative capacity, others retain the potential to participate in therapeutic interventions. Inflammatory Mechanisms and Gliosis The CNS is no longer regarded strictly as an “immunologically privileged site” with limited access of antibodies and inflammatory mediators through the blood-brain barrier. Traumatic brain injury is a neuroinflammatory condition of the CNS, in which rupture of the

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Fawaz Al-Mufti, Krishna Amuluru, Abhinav Changa, Megan Lander, Neil Patel, Ethan Wajswol, Sarmad Al-Marsoummi, Basim Alzubaidi, I. Paul Singh, Rolla Nuoman, and Chirag Gandhi

T he incidence and impact of traumatic brain injury (TBI) within the general population have increased over the past few years. 6 Although the primary injury associated with TBI may be debilitating, secondary injury associated with posttraumatic arterial vasospasm is an important and dangerous consequence of TBI. The incidence of vasospasm in aneurysmal subarachnoid hemorrhage (aSAH) has been extensively studied; less is known regarding the epidemiology of posttraumatic vasospasm (PTV), with the largest study examining only 299 patients. 25 Because of limited