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Published Online: 1 April 2013

Concepts and Strategies for Clinical Management of Blast-Induced Traumatic Brain Injury and Posttraumatic Stress Disorder

Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

The authors explain and detail the effects of the kinetic energy of blast shock waves on the CNS, specifically, the volumetric blood surge through the brain and large and small blood vessels and its neuropsychiatric effects. In addition to the physical and/or cognitive effects of blast injury, this pressure effect may be associated with posttraumatic stress disorder and reactive depression.

Abstract

After exposure of the human body to blast, kinetic energy of the blast shock waves might be transferred into hydraulic energy in the cardiovascular system to cause a rapid physical movement or displacement of blood (a volumetric blood surge). The volumetric blood surge moves through blood vessels from the high-pressure body cavity to the low-pressure cranial cavity, causing damage to tiny cerebral blood vessels and the blood–brain barrier (BBB). Large-scale cerebrovascular insults and BBB damage that occur globally throughout the brain may be the main causes of non-impact, blast-induced brain injuries, including the spectrum of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). The volumetric blood surge may be a major contributor not only to blast-induced brain injuries resulting from physical trauma, but may also be the trigger to psychiatric disorders resulting from emotional and psychological trauma. Clinical imaging technologies, which are able to detect tiny cerebrovascular insults, changes in blood flow, and cerebral edema, may help diagnose both TBI and PTSD in the victims exposed to blasts. Potentially, prompt medical treatment aiming at prevention of secondary neuronal damage may slow down or even block the cascade of events that lead to progressive neuronal damage and subsequent long-term neurological and psychiatric impairment.

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Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 103 - 110
PubMed: 23686026

History

Received: 12 March 2012
Accepted: 5 July 2012
Published online: 1 April 2013
Published in print: Spring 2013

Authors

Details

Yun Chen, M.D., Ph.D.
From BrightstarTech, Inc. Clarksburg, MD (YC); Uniformed Services University of the Health Sciences, Bethesda, MD (WH); Dept. of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel (SC).
Wei Huang, M.B.
From BrightstarTech, Inc. Clarksburg, MD (YC); Uniformed Services University of the Health Sciences, Bethesda, MD (WH); Dept. of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel (SC).
Shlomi Constantini, M.D., M.Sc.
From BrightstarTech, Inc. Clarksburg, MD (YC); Uniformed Services University of the Health Sciences, Bethesda, MD (WH); Dept. of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel (SC).

Notes

Send correspondence to Dr. Yun Chen, BrightstarTech, Inc.; e-mail: [email protected]

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