VASCULAR INJURIES OF THE BRAIN IN BLAST-INDUCED TRAUMATIC BRAIN INJURY (LITERATURE REVIEW)

Vascular injuries of the brain caused by blast trauma represent one of the most complex challenges in modern neurotraumatology, as they combine mechanical, barotraumatic, and biochemical mechanisms of damage.The primary impact of the blast wave leads to a rapid pressure surge that causes micro-and macrovascular ruptures, disruption of the blood-brain barrier (BBB), formation of microhemorrhages, and impairment of cerebral perfusion.The pathophysiological basis of these changes is the mechanical deformation of the neurovascular unit, which triggers a cascade of secondary injuries.This article provides a detailed overview of the mechanisms underlying primary and secondary vascular damage, including endothelial dysfunction, glial cell activation, neuroinflammation, oxidative stress, and imbalances in vasoactive factors.Special attention is given to the role of proinflammatory cytokines, matrix metalloproteinases, and coagulation factors in the development of progressive cerebral edema and microcirculatory disturbances.The pathogenesis of chronic consequences of blast trauma is examined, including persistent vascular insufficiency, chronic hypoperfusion, impaired cerebral blood flow autoregulation, and the development of post-traumatic encephalopathy.Molecular mechanisms of vascular wall remodeling and the role of hypoxia-inducible factors in post-traumatic adaptation processes are also highlighted.The article analyzes current methods for diagnosing vascular damagefrom neuroimaging techniques (CT, MRI, perfusion studies) to laboratory biomarkers of endothelial injury and BBB disruption.Current treatment and prevention strategies for secondary injuries are discussed, including management of perfusion pressure, therapies aimed at endothelial stabilization, anti-inflammatory and antioxidant approaches, as well as prospects for neuroprotective interventions.This literature review summarizes clinical, experimental, and molecular findings that shape the modern understanding of vascular mechanisms of brain injury following blast exposure.The results emphasize the need for a comprehensive, multidisciplinary approach to managing patients with blast