Pathology of blast-related brain injury

Abstract

Abstract-Blasts are responsible for about two-thirds of the combat injuries in Operation Iraqi Freedom and Operation Enduring Freedom, which include at least 1,200 traumatic brain injuries. Blasts inflict damage to the brain directly and by causing injuries to other organs, resulting in air emboli, hypoxia, and shock. Direct injuries to the brain result from rapid shifts in air pressure (primary blast injury), from impacts with munitions fragments and other objects propelled by the explosion (secondary blast injury), and from collisions with objects and rapid acceleration of individuals propelled by the explosion (tertiary blast injury). Tertiary injury can occur from a building or other structure collapsing and from an individual being thrown by the blast wind. The pathological consequences of secondary and tertiary blast injuries are very likely to be similar to those of other types of mechanical trauma seen in civilian life. The damage attributable to the specific effects of a blast, however, has received little study, although it has been assumed to include the focal and diffuse lesions characteristic of closed head injuries. Available clinical studies of blast injuries show focal damage similar to that found in other types of closed head injuries but have not determined whether diffuse axonal injury also occurs. In this article, we will try to reach a better understanding of the specific pathology of blast-related brain injury by reviewing the available experimental studies and the autopsy reports of victims of terrorist attacks and military casualties dating back to World War I.

Effectiveness of gfap in determining neuron damage in rats with induced head trauma

“…Apoptosis continues at times when necrosis is presumed to have ceased (25). In the current study, the number of apoptotic cells significantly increased in the perilesional space (18,22,25,27). Our histopathological findings, such as vascular congestion, hemorrhage, edema and axonal swelling, are consistent with the findings of authors.…”

“…It occurs under physiological as well as pathophysiological conditions. Apoptosis also plays an important role in neurodegenerative, myeloplastic and ischemic nervous system disorders and likely contributes to cell death after TBI (18,22,25,27). There are few reports of apoptosis after focal contusion induced by controlled cortical impact.…”

The Yin and Yang of Integrated Care: Systemic Imperatives for Traumatic Brain Injuries

“…Severe traumatic brain injuries afflict about 30 per cent of the total brain injury population and carry a 90 per cent mortality rate [29]. For those who have sustained blast trauma in militarized or violent zones, the long-term societal impacts of permanent brain injuries are even more significant [15,16,30]. For brain injury survivors, the physiological and psychological consequences have a deleterious impact on the psycho-social integrity and functioning.…”

Blast injury: A case study

“…When a high-explosive detonates (such as gelignite, trinitrotoluene, C4 or Semtex), an increase in air pressure is created, known as an overpressure or blast wave, which travels supersonically up to 8000 m/s (Cullis, 2001). This overpressure attains its peak pressure in the first few milliseconds following the blast (Owers et al, 2010), and can reach pressures of 20-30 kbar, where 1 kbar is 1000 times atmospheric pressure (Kocsis and Tessler, 2009). As the blast wave expands, the energy of the blast wave dissipates and the pressure decreases.…”