Meet the editor

Yongxia Zhou completed her PhD from the University of Southern California in Biomedical Imaging (2004). Her research interest is radiology and neuroscience applications. She was trained and has worked as a neuroimaging scientist in several prestigious institutes, including Columbia University, University of Pennsylvania, and NIH. Her research focuses on multimodal neuroimaging integration, including MRI/PET and EEG instru-

mentation, and makes best use of multiple modalities to help interpret underlying disease mechanisms. She has authored more than five monograph books, and edited several books for well-known publishers, including IntechOpen and Nova Science. She has published over 100 papers and abstracts and served as a reviewer and editor for many reputed international journals and conferences.

Contents

**Section 1**

**Section 2**

**Section 3**

Sedation in TBI Patients

Post Concussion Syndrome

*by Mohammad Nadir Haider and Itai Bezherano*

*by Marina Martinez-Vargas, Mercedes Graciela Porras-Villalobos,* 

Cumulative Mild Head Injury (CMHI) in Contact Sports

*by Alexander Rodríguez, Eliana Cervera and Pedro Villalba*

Use of Neuroprotective agents for Traumatic Brain Injury

Direct Brain Cooling in Treating Severe Traumatic Head Injury

*Mohd Hasyizan Bin Hassan and Wan Nazaruddin Wan Hassan*

*by Lorenzo Peluso, Berta Monleon Lopez and Rafael Badenes*

Neuronal and Glial Biomarkers Research for Traumatic Brain Injury

*by Mohammad Meshkini, Ali Meshkini and Homayoun Sadeghi-Bazargani*

Neuroprotection, Photoperiod, and Sleep

*Antonio Barajas-Martinez and Luz Navarro*

*by Kathryn Nel and Saraswathie Govender*

**Preface III**

Disease Etiology and Post Concussion Syndrome **1**

**Chapter 1 3**

**Chapter 2 23**

Imaging Diagnosis and Biomarkers **41**

**Chapter 3 43**

**Chapter 4 67**

Treatment and Multiple Therapeutic Strategies **85**

**Chapter 5 87**

**Chapter 6 123**

**Chapter 7 141**

*by Zamzuri Idris, Ang Song Yee, Regunath Kandasamy, Asrulnizam Abd Manaf,* 

*Francisco Estrada-Rojo, Ricardo Jesus Martinez-Tapia, Adan Perez-Arredondo,* 

## Contents


*by Lorenzo Peluso, Berta Monleon Lopez and Rafael Badenes*

Preface

Traumatic brain injury (TBI) is the leading cause of mortality and morbidity with a high incidence in young people all over the world. Post-concussive syndrome (PCS) is an international public health concern with 5–10% of mild TBI (mTBI) cases experiencing concussion in their lives and about 20% of patients having persistent PCS within 6 months to 1 year after mTBI. There are many advanced techniques and methods for the investigation of brain changes and treatments in TBI patients and each of these techniques provides important insights into pathophysiology due to head injury but may not be limited to conventional methods. This new information emerges to give a broad picture of TBI research and clinical evaluation such as cumulative mild head injury (CMHI), novel neuroimaging findings and biomarkers, neuroprotective treatments, brain cooling, and sedation in TBI patients, as well

The first section of the book introduces disease neurobiology and PCS. Chapter 1 "Post-Concussion Syndrome" describes the definition of PCS, classification, and association with brain dysfunction, blood flow regulation, intracranial pressure change, and the role of neuroinflammation, as well as long-term sequelae such as chronic traumatic encephalopathy and treatment. Discussing PCS problems in TBI for the improvement of clinical diagnosis based on several definitions is challenging given subjective and gross aspects of the assessments of PCS, e.g. Glasgow comma scale and loss of conscious. This chapter provides many characteristics of PCS, including classification, association with autonomic nervous system dysfunction, brain changes, and treatment that could serve as a reference resource for further research. Chapter 2 "Neuroprotection, Photoperiod, and Sleep" investigates the neurobiological basis of neuroprotective activation, and correlation with PCS, including sleep. The authors attempt to explain the neurobiological basis of neuroprotective activation, adaptive response to photoperiod possibly due to injury of the suprachiasmatic nucleus, and correlation with post-traumatic symptoms, including sleep, as well as limitations. This chapter provides clues to studying the relationships between neuroprotection and sleep as well as the involved neurotransmission

The second section of the book covers the imaging diagnosis and biomarkers in TBI. Chapter 3 "Cumulative Mild Head Injury (CMHI) in Contact Sports" provides a CMHI review, brain changes, and risk factors. This chapter briefly overviews the structure and neuroanatomy of brain change to illustrate the pathophysiological mechanisms involved in primary and secondary head injuries. Some relatively new imaging perspectives, including diffusion axonal injury, close-head injury, homeostasis irregulation, and tauopathy, are illustrated concisely. Risk factors for all types of CMHI are described further with details for early prevention and cure. Chapter 4 "Neuronal and Glial Biomarkers Research for Traumatic Brain Injury" studies multiple biomarkers, including S-100β, UCH-L1, and GFAP for blood–brain barrier breakdown and neuronal injury. The sensitivity and specificity of each biomarker from published articles as well as the ratio between GFAP and UCH-L1 are reported with confirmative statistical results and table summaries. This chapter gives a full overview of the most promising biomarkers studied as predictors of the severity

as neuronal and glial biomarkers.

systems.
