Head trauma associated with a depressed GCS.<unk> : accounts for approximately 10% of traumatic brain<unk> .<unk> : accounts for approximately 10% of traumatic brain<unk> .
Traumatic Brain<unk>  (TBI): Impairment in brain function from a mechanical force
Contusions
Bruises to brain parenchyma
Hematomas
Epidural hematoma
Subdural hematoma
Intraparenchymal
Intraventricular
Subarachnoid hemorrhage
Diffuse axonal<unk> 
Direct cellular damage
Neurons
Axons
Tearing and shearing of tissues
Bruises to brain parenchyma
Epidural hematoma
Subdural hematoma
Intraparenchymal
Intraventricular
Subarachnoid hemorrhage
Neurons
Axons
Brain swelling causes increased ICP which compresses the tissue causing ischemia with direct compression of the vasculature causing brain tissue herniation and brain death
Leads to expansion of the original<unk>  (predominantly metabolic insult)
Calcium and sodium shifts
Mitochondrial damage
Production of free radicals
Ultimately leads to damage to axonal integrity and axonal transport
Enzyme activity leads to apoptosis
Microscopic structural<unk>  is often unidentifiable on CT or MRI
Calcium and sodium shifts
Mitochondrial damage
Production of free radicals
Enzyme activity leads to apoptosis
vasoconstriction
HTN, Hypocarbia, alkalosis
No good way to measure cerebral blood flow
Use CPP as surrogate
CPP is amount of pressure needed to perfuse the brain
CPP=MAP-ICP
When ICP elevates, CPP decreases
Normal ICP
15 in adults
<10 to 15 in children
1.5 to 6.0 in infants
Autoregulation allows the body to control the cerebral blood flow
Autoregulatory mechanism is damaged in most TBI patients
HTN, Hypocarbia, alkalosis
Use CPP as surrogate
CPP is amount of pressure needed to perfuse the brain
CPP=MAP-ICP
When ICP elevates, CPP decreases
Normal ICP
15 in adults
<10 to 15 in children
1.5 to 6.0 in infants
CPP is amount of pressure needed to perfuse the brain
CPP=MAP-ICP
When ICP elevates, CPP decreases
Normal ICP
15 in adults
<10 to 15 in children
1.5 to 6.0 in infants
When ICP elevates, CPP decreases
Normal ICP
15 in adults
<10 to 15 in children
1.5 to 6.0 in infants
15 in adults
<10 to 15 in children
1.5 to 6.0 in infants
Autoregulatory mechanism is damaged in most TBI patients
Moderate-to-severe traumatic brain injury
Traumatic brain injury
Mild traumatic brain injury
Intracranial hemorrhage
Ventriculoperitoneal shunt complications
Cerebral edema in brain cancer
Elevated intracranial pressure
Brain herniation syndromes