Repeated blast-induced neurotrauma (systematic review)

Abstract

During military conflicts, explosive injuries are observed, in particular, explosion-induced neurotrauma, which leads to significant impairment of brain functions and deterioration of the quality of life of the victims. Therefore, the study of the pathogenesis of such injuries is definitely relevant. Attention is drawn to repetitive blast-induced neurotrauma, because gunners and tankers, as well as civilians living in areas where such weapons are used, are most often exposed to it. In order to establish the already investigated features of the clinical and experimental course of mild repetitive blast-induced trauma, the aim of the work was to conduct a retrospective and prospective analysis of literary sources dedicated to the study of the features of the mechanisms of damage to the central nervous system after repeated blast wave action. To achieve the goal, a retro- and prospective analysis of literature and patents for the period 2003–2023 was conducted. As a result of the analysis, it was established that the action of the blast wave can cause a mild brain injury and that its repeated exposure leads to more serious consequences. These consequences include: diffuse axonal damage, oxidative stress, tissue damage, hemorrhage, vasoconstriction, edema, pseudoaneurysm formation, and induction of apoptosis. It can also be said that, in contrast to a single exposure, repeated exposure to a blast wave has a cumulative effect on different areas of the brain and causes chronic neuropathological changes. Dissociation of cerebral blood flow and metabolism, excitotoxicity, oxidative stress, cell death, astrocyte reactivity, blood-brain barrier dysfunction, microglia activation, dysmyelination, diffuse axon damage play a leading role in the pathogenesis of repeated blast-induced neurotrauma. Keywords: central nervous system, blast wave, brain, trauma.