Traumatic brain injury (TBI) is a major cause of lifelong disability and death worldwide, but is considered a 'silent epidemic' as society is largely unaware of the magnitude of the problem. Repetitive brain injuries can cause a neurodegenerative disorder termed chronic traumatic encephalopathy (CTE), as has been highly publicized in recent years in cases of retired participants of high-impact sports such as boxing and American football. In this special Focus Issue, experts in TBI and CTE review the causes, pathology, consequences and epidemiology of brain injury, as well as highlighting advances in prevention, detection and monitoring of TBI.



EDITORIAL

Read all about it! Why TBI is big news

Katy Malpass

doi:10.1038/nrneurol.2013.55

Nature Reviews Neurology 9, 179 (2013)

NEWS & VIEWS

Traumatic brain injury: Intracranial pressure monitoring in traumatic brain injury

Bertil Romner & Per-Olof Grände

doi:10.1038/nrneurol.2013.37

Nature Reviews Neurology 9, 185-186 (2013)

Traumatic brain injury: Giving voice to a silent epidemic

Martin Rusnak

doi:10.1038/nrneurol.2013.38

Nature Reviews Neurology 9, 186-187 (2013)

REVIEWS

Acute and chronic traumatic encephalopathies: pathogenesis and biomarkers

Steven T. DeKosky, Kaj Blennow, Milos D. Ikonomovic & Sam Gandy

doi:10.1038/nrneurol.2013.36

Nature Reviews Neurology 9, 192-200 (2013)

Traumatic brain injury (TBI) can occur as a single severe cranial impact or as repetitive concussions, and commonly affects professional athletes in contact sports and soldiers exposed to explosions. DeKosky and colleagues describe the distinct pathological changes accompanying each type of TBI, and characteristics of the resultant neuropathology, which frequently involves amyloid-β and tau aggregates. Potential biomarkers of TBI-induced damage are also outlined.

Biomarkers of mild traumatic brain injury in cerebrospinal fluid and blood

Henrik Zetterberg, Douglas H. Smith & Kaj Blennow

doi:10.1038/nrneurol.2013.9

Nature Reviews Neurology 9, 201-210 (2013)

Mild traumatic brain injury (TBI) is defined as a head trauma resulting in a brief loss of consciousness and/or alteration of mental state. Diagnostic methods to determine the extent of injury to the brain and potential long-term damage in patients are lacking. In this Review, the authors discuss the need for fluid biomarkers of mild TBI, and the potential validation of biomarkers before clinical implementation.

Chronic neuropathologies of single and repetitive TBI: substrates of dementia?

Douglas H. Smith, Victoria E. Johnson & William Stewart

doi:10.1038/nrneurol.2013.29

Nature Reviews Neurology 9, 211-221 (2013)

The link between traumatic brain injury and dementia has long been recognized, and has gained additional prominence through recent high-profile reports of chronic traumatic encephalopathy (CTE) in athletes exposed to repetitive head injury. In this Review, Smith et al. outline the neuropathological features of CTE that are thought to contribute to cognitive impairment, and discuss the work that remains to be done to define CTE as a distinct disease entity.

The clinical spectrum of sport-related traumatic brain injury

Barry D. Jordan

doi:10.1038/nrneurol.2013.33

Nature Reviews Neurology 9, 222-230 (2013)

Traumatic brain injuries (TBIs) sustained by athletes in contact–collision sports can cause long-term neurological complications. In recent years, cases of chronic traumatic encephalopathy—a neurodegenerative sequela of repetitive TBI—in retired boxers and American football players have been highly publicized. Here, Barry Jordan reviews the spectrum of sport-related brain injuries, and outlines the need for appropriate detection and management of both acute and chronic TBIs in athletes.

Changing patterns in the epidemiology of traumatic brain injury

Bob Roozenbeek, Andrew I. R. Maas & David K. Menon

doi:10.1038/nrneurol.2013.22

Nature Reviews Neurology 9, 231-236 (2013)

In this Perspectives article, Roozenbeek et al. discuss issues with epidemiological studies in traumatic brain injury (TBI) and variability in the definition of such injuries. They describe how changing epidemiological patterns have influenced mortality and outcomes following brain injury, and identify the need for standardized epidemiological monitoring in TBI.

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