الفهرس 
Anatomical and Physiological Aspects of
D- Pathophysiology of toxic-metabolic brain injuryOnly 14 pages are availabe for public view
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Abstract
Abstract
Traumatic brain injury (TBI) may be blunt head injuries, penetrating head injuries, and blast head injuries. Also, traumatic brain injury may be mild, moderate, or severe. A Glasgow Coma Score (GCS) of 13 to 15 is considered mild, 9 to 12 moderate, and GCS of 8 or less severe.
Non traumatic brain injuries include vascular brain injuries (acute ischemic stroke, intracerebral hemorrhage and subarachinoid hemorrhage), hypoxic-ischemic brain injury, toxic-metabolic brain injury, inflammatory brain injury and Infectious brain injury (Infectious encephalitis)
The examination of brain injured patient should begin with an assessment of vital signs. Not only this allows evaluation of the stability of the patient, it also provides clues to the etiology of the patient’s unresponsiveness e.g. hyperthermia can be seen in midbrain hemorrhage and infection. Similarly, hypertension can be secondary to increased intracranial pressure, or indicative of posterior reversible encephalopathy syndrome (PRES). Hypotension can point toward sepsis or progression to brain death.
The primary goal of the neurologic examination in brain injured patient is to localize the lesion and narrow the differential diagnosis. The examination should proceed in a stepwise fashion and be familiar to the neurologist because of constant repetition. In the process of the comprehensive neurologic examination, the depth of coma should be determined using a coma scale. The Glasgow Coma Scale (GCS) is the most common of such scales.
Head tomography is essential upon suspicion of brain injury and must be the first image requested. It is performed in a few seconds, is available in most emergency services and has good sensitivity to detect bleeding (subarachnoid hemorrhage, subdural hematoma, epidural hematoma, or intraparenchymal hematoma), hydrocephalus, tumors and extensive brain infarcts. On suspicion of meningitis, carry out head tomography whenever possible prior to per¬forming lumbar puncture, since herniation of the brain¬ stem is a real possibility in the presence of intracranial hypertension.
Conclusion
The brain can be injured in many different ways. The type of injury can affect just one or several parts of the brain which are responsible for different functions. Each brain injury is unique, so that symptoms can vary widely. Acute brain injury may be traumatic or non traumatic. Acute brain injury, whatever its cause, is associated with short- and long-term morbidity and mortality.
Keywords: Acute Brain Injury; Critically Ill patients
References
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Amorim RL, Nagumo MM, Paiva WS, et al. (2016): Current clinical approach to patients with disorders of consciousness. Rev Assoc Med Bras; 62(4): 377-384