Biochemical and Molecular Mechanisms after Severe Traumatic Brain Injury in Children

Abstract

Secondary damage after severe traumatic brain injury (TBI) in infants and children represents the key target for the development and application of novel therapies. Our group at the Safar Center for Resuscitation Research and the Children’s Hospital of Pittsburgh has put considerable effort into defining the mechanisms involved in the evolution of damage after severe TBI in pediatric patients and has also worked to develop and use experimental models of TBI to evaluate both novel diagnostic tools and putative therapies. In this chapter, we outline some of our most recent findings on a number of exciting fronts. First, we will update our work at the bedside that takes advantage of the cerebrospinal fluid (CSF) bank that we have accumulated from infants and children with severe TBI. The CSF bank, funded by the Centers for Disease Control and Prevention in the USA, is a unique resource that includes over 1000 CSF samples from nearly 100 pediatric victims of severe TBI. The CSF bank has become instrumental in studying biochemical and molecular mechanisms in our critically ill patients. For a review of the initial investigations of secondary injury mechanisms in pediatric TBI by our group, we suggest two recent reviews [1, 2]. The investigations by our group discussed in this chapter represent the more recent studies (Fig. 1).