Specific brain injuries seen in patients with a TBI include: Skull fractures - linear, compound, depressed or basilar. Concussions - see section on concussions Contusions - an area of focal edema, with or without hemorrhage, visible on CT. There may be loss of consciousness (LOC) or even focal deficits. Epidural and/or subdural hematomas Diffuse axonal injury - Shearing forces cause tearing of long axonal fibers and disruption of myelin. CT may show visible tears in the white matter, but more often reveals diffuse cerebral edema. Trauma is characterized by an intense inflammatory response, as well as a hypermetabolic state characterized by increased cortisol and insulin resistance. This can result in the physiologic changes listed at the right, which can produce significant secondary brain injury. hypoxia hypotension hyperthermia hypocarbia hyperglycemia "Clinical" Pages: Previous 1 2 3 4