%0 Journal Article
%T Molecular mechanisms of traumatic brain injury: the missing link in management
%A Tonny Veenith
%A Serena SH Goon
%A Rowan M Burnstein
%J World Journal of Emergency Surgery
%D 2009
%I BioMed Central
%R 10.1186/1749-7922-4-7
%X Our understanding of the molecular mechanisms of traumatic brain injury (TBI) has improved over the last decade, but a gap still exists between these advances and their translation into direct clinical care. About 0.5¨C1 million patients present to hospitals in the UK with TBI. It is the leading cause of disability in people under 40, and severely disables 150¨C200 people per million annually [1,2]. In the US, TBI affects 1.4 million people, at an estimated annual cost of $56 billion [3]. Diseases of the nervous system (International Classification of Diseases-revision 9) accounted for 8.4% of the total health and social services net public expenditure for 1992 and 1993 in England [4]. The purpose of this review is to look at genetic and molecular influences after an acute head injury and the long term outcome.Although our ability to assess and predict neurological outcome following TBI has improved, most of the prognostic tools are still poorly validated and therefore rarely used [5]. Understanding the molecular mechanisms and integrating these into clinical practice will help us to predict outcomes more accurately, and will also pave the way for newer treatment modalities and further research.Current understanding of the basic molecular mechanisms resulting in neurological damage following TBI has sparked several significant attempts to synthesise drugs (e.g. Selfotel) [6]. So far these attempts have universally met with little success clinically, but they have provided some insights for future research [6]. Such research has been hampered by a lack of translation of results from animal models into humans. Despite this it is likely that such work, both in animal models and observational studies in patients with acute TBI will continue to shed light in this important subject.Acute TBI is characterised by two injury phases, primary and secondary. The primary brain injury is the direct injury to the brain cells incurred at the time of the initial impact. This results i
%U http://www.wjes.org/content/4/1/7