Congenital and acquired brain injury. 1. Brain injury: Epidemiology and pathophysiology

This self-directed learning module highlights recent advances in the understanding of brain injury pathophysiology, epidemiology, severity scales, and treatment interventions to minimize brain injury in adults and children. It is part of the chapter on congenital and acquired brain injury in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. In this article, brain injury epidemiology is summarized, and differences in between brain injury in pediatric and elderly persons are highlighted. Underlying physiologic and chemical mechanisms for secondary brain injury are reviewed, along with strategies and research to minimize this injury. Contemporary understanding of the mechanisms and treatments of brain injury in preterm infants is also discussed. Classification of brain injury severity provides a way to stratify this heterogeneous group. Overall Article Objective: (a) To summarize brain injury epidemiology and prevention strategies across the age spectrum, (b) to review the pathophysiology of pediatric and adult brain injury, and (c) to classify brain injury by severity scales.