ABSTRACT
Traumatic brain injuries can be classified into penetrating and closed-head injuries. In penetrating head injury, cerebral pathology tends to be localized around the path of the missile. Rotational acceleration usually occurs with the presence of rotation about the center of gravity of the brain, with no movement to the center of gravity itself. The pathophysiology of TBI results from compression and deformation of the skull and begins at the time of impact but continues over a period of days, weeks, or even longer. Diffuse axonal injury (DAI) is a common characteristic in TBI. Intracerebral hematomas occur within the brain parenchyma and often follow the same spatial distribution as contusions. Recent research has suggested that further secondary damage may be due to neurochemical processes, mediated by a cascade of biochemical and metabolic reactions. Further, methods for diagnosing injury, determining severity, managing potentially preventable secondary consequences, and predicting outcomes remain inaccurate.
