Spine trauma: Difference between revisions
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### Pathophysiology | |||
| Injury Phase | Time Relative to Primary Injury | Key Processes and Events | | |||
| --- | --- | --- | | |||
| Immediate | <2 hours | | |||
- Primary mechanical injury (severing of axons) | |||
- Gray matter hemorrhage and ischemia | |||
- Microglial activation | |||
- Release of pro-inflammatory factors (IL-1β, TNFα, IL-6) | |||
| | |||
| Early acute | <48 hours | | |||
- Vasogenic and cytotoxic edema | |||
- ROS production, lipid peroxidation | |||
- Glutamate-mediated excitotoxicity | |||
- Continued hemorrhage, ischemia, and necrosis | |||
- Neutrophil invasion | |||
- Peak BSCB permeability | |||
- Early demyelination (oligodendrocyte death) | |||
- Neuronal death | |||
- Axonal swelling | |||
- Systemic events (systemic shock, spinal shock, hypotension, hypoxia) | |||
| | |||
| Subacute | <14 days | | |||
- Macrophage infiltration | |||
- Initiation of astroglial scar (reactive astrogliosis) | |||
- BSCB repair and resolution of edema | |||
| | |||
| Intermediate | <6 months | | |||
- Continued formation of glial scar | |||
- Cyst formation | |||
- Lesion stabilization | |||
| | |||
| Chronic | >6 months | | |||
- Prolonged Wallerian degeneration | |||
- Persistence of spared, demyelinated axons | |||
- Potential structural and functional plasticity of spared spinal cord tissue | |||
| | |||
[[Category:Neurotrauma]] | [[Category:Neurotrauma]] | ||
Revision as of 13:11, 3 February 2024
- Pathophysiology
| Injury Phase | Time Relative to Primary Injury | Key Processes and Events | | --- | --- | --- | | Immediate | <2 hours |
- Primary mechanical injury (severing of axons) - Gray matter hemorrhage and ischemia - Microglial activation - Release of pro-inflammatory factors (IL-1β, TNFα, IL-6)
|
| Early acute | <48 hours |
- Vasogenic and cytotoxic edema - ROS production, lipid peroxidation - Glutamate-mediated excitotoxicity - Continued hemorrhage, ischemia, and necrosis - Neutrophil invasion - Peak BSCB permeability - Early demyelination (oligodendrocyte death) - Neuronal death - Axonal swelling - Systemic events (systemic shock, spinal shock, hypotension, hypoxia)
|
| Subacute | <14 days |
- Macrophage infiltration - Initiation of astroglial scar (reactive astrogliosis) - BSCB repair and resolution of edema
|
| Intermediate | <6 months |
- Continued formation of glial scar - Cyst formation - Lesion stabilization
|
| Chronic | >6 months |
- Prolonged Wallerian degeneration - Persistence of spared, demyelinated axons - Potential structural and functional plasticity of spared spinal cord tissue
|