Traumatic Brain Injury and Spinal Cord Injury: Pathophysiology and Acute Therapeutic Strategies

The cellular cascades of damage to the central nervous system (CNS) are becoming increasingly clear. The foundation of evidence is based primarily on animal models. Although there is a growing body of knowledge of therapeutics for traumatic brain injury (TBI) and spinal cord injury (SCI), the literature is scanty in addressing therapeutic intervention for both. It is unclear why current treatment protocols are proven to be effective in one neurotrauma subpopulation and not efficacious in another group. For instance, methylprednisolone has been noted to be associated with worse outcome in penetrating SCI, yet to be beneficial in other traumatic SCI causes. This article will review the anatomical basis, common pathophysiological processes, and therapeutics for TBI and SCI. A broad overview of current beliefs regarding management techniques and novel neuroprotective therapies, which may eventually influence functional outcome, will be presented for the rehabilitation professional.