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Other macrophages return to or remain in theseptal connective tissue, where, filled with accumulatedphagocytized material, they may remain for much of anindividual’s life (Fig. The major pathway leads to mitochondrial-induced apoptosis and is the result of multiple pro-apoptotic factors that are released from themitochondrial membrane such as Smac/Diablo, Omi/HtrA2, and cytochrome c. Research stronglyindicates that providing patients with psycho-educational information early in the recoveryprocess can have a dramatic effect on their abil-ity to cope with ABI (Mittenberg, Tremont,Zielinski, Fichera, & Rayls, 1996; Ponsfordet al., 2002)

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Many criticisms are alsolevied at inherent weaknesses in psychometric measures, such as cultural bias andtheroleofenvironmentalstimulationonperformanceoutcomes.Concernsmightaddress the snapshot quality of a test result that portrays merely a point in timeor, at best, a point within a de?nable range, rather than a dynamic ongoing pro-cess. Follow-up CT scans are commonly ordered for patients in the neurointensivecare unit when there is any concern for hematoma expansion or mass effect (Figure 8.10).Occasionally, such patients require subacute surgical interventions.

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