Secondary brain injury seen in:
Ans: C (Seizures) Ref: .J. Claude Hemphill. Multimodal Monitoring and Neurocritical Care Bioinformatics: Secondary Brain Injury. Med scape education.Explanation:When patients have an acute neurological catastrophe such as traumatic brain injury (TBI) or stroke, damage to the brain can occur at the time of the initial event.This damage is termed primary brain injury, and the underlying mechanisms include:Intraparenchymal or extra-axial traumatic or spontaneous hemorrhageDiffuse axonal injury (in TBI)Focal or global ischemia from acute ischemic stroke or global cerebral ischemia during cardiac arrest.Although interventions (eg: surgical hematoma evacuation ) can be undertaken to limit or reverse primary brain injury, much of the primary damage may be irreversible.This primary brain injury initiates a cascade of biochemical events that are rexersible. This process is termed secondary brain injurySecondary brain injury can generally be considered as two related concepts:Cellular injury cascadesSecondary brain insults (SBIs).An example of the cellular injury cascade is the ischemic cascade in which events such as excitotoxicity, intracellular calcium influx, and free radical membrane damage are ongoing.Hence, ultra-early ischemic stroke treatment via revascularization of an occluded intracranial artery with thrombolytic agents is intended to restore perfusion before permanent cell death, thereby reversing this secondary brain injury.In addition to initiating ischemic and apoptotic cell injury cascades, primary brain injuries make injured, but salvageable, brain tissue vulnerable to SB Is.Hypotension, hypoxia and hypoglycemia are all examples of SBIs in which decreased substrate delivery to an injured brain further worsens injury.On the other hand, fever, seizures and hyperglycemia are examples of SBIs in which increased metabolic demand may outstrip compensator) mechanisms and result in further injury.Examples of primary and secondary brain injury in TBIPrimarySecondary* Intracerebral fiemorrnage* Subdural hemorrhage* Subarachnoid hemorrhage* Epidural hemorrhage* Cerebral contusion* Cerebral laceration* Axonal stretch injury* Edema* Impaired metabolism* Altered cerebral blood flow* Free radical formation* Excitotoxicity* Increased inlracracial tension* Seizures
Concussion
Diffuse axonal surgery
Seizures
Intracrebral hematoma
Traumatic Brain Injury