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Progenitor Cell Therapy for Neurological Injury pp 97–122Cite as

Traumatic Brain Injury Pathophysiology/Models

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Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

Abstract

Traumatic brain injury (TBI) represents a major burden on health care worldwide. In the US, TBI accounts for 435,000 emergency department visits, 37,000 hospital admissions, and approximately 2,500 deaths each year. Of the patients affected, 48% are impaired by chronic physical, cognitive, and psychosocial deficits. While aggressive early rehabilitation improves function (Cowen et al. Arch Phys Med Rehabil 76:797–803, 1995; Gray and Burnham Arch Phys Med Rehabil 81:1447–1456, 2000), the acute care of TBI with focus on controlling intracranial pressure (ICP) while maintaining adequate cerebral perfusion has not shown the ability to reverse neuronal injury on either a cellular or subcellular level. The National Institutes of Health (NIH) recently convened a meeting to discuss the complex pathophysiology of neuronal injury and the failure of all trials based on current monotherapies (controlled hypothermia, hyperosmotic infusion) to date. Recommendations included the development of in vitro models to research multimodality treatments that could target several mechanisms of TBI’s complex pathophysiology (http://www.nih.gov; Walker et al. J Trauma. 2009).

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Abbreviations

ASC:

Adipose-derived stem cell

ATP:

Adenosine triphosphate

BDNF:

Brain-derived neurotrophic factor

CBF:

Cerebral blood flow

CCI:

Controlled cortical impact

CNS:

Central nervous system

CSF:

Cerebral spinal fluid

CT:

Computed tomography

DAI:

Diffuse axonal injury

EGF:

Epidermal growth factor

FDG-PET:

Flurodeoxyglucose-positron emission tomography

FGF:

Fibroblast growth factor

FPI:

Fluid percussion injury

GCS:

Glasgow coma scale

GOS:

Glasgow outcome score

HGF:

Hepatocyte growth factor

HTS:

Hypertonic saline

hUCB:

Human umbilical cord blood

ICP:

Intracranial pressure

IGF-1:

Insulin-like, growth factor 1

MAP:

Mean arterial pressure

MBP:

Myelin basic protein

MSC:

Mesenchymal stromal cell

NAC:

N-Acetylcysteine

NGF:

Nerve growth factor

NIH:

National Institutes of Health

NSC:

Neuronal stem cell

NSE:

Neuron-specific enolase

TAI:

Traumatic axonal injury

TBI:

Traumatic brain injury

TNF-α:

Tumor necrosis factor-alpha

VEGF:

Vascular endothelial growth factor

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Authors and Affiliations

  1. Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA

    Peter A. Walker

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  1. Peter A. Walker
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  2. Nathan D. Allison
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Correspondence to Peter A. Walker .

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  1. Medical School at Houston, Div. Pediatric Surgery, University Texas, Fannin Street 6431, Houston, 77030, Texas, USA

    S. Charles Jr.

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Walker, P.A., Allison, N.D. (2011). Traumatic Brain Injury Pathophysiology/Models. In: Charles, S. (eds) Progenitor Cell Therapy for Neurological Injury. Stem Cell Biology and Regenerative Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-965-9_5

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