Focal and diffuse brain injury are ways to classify brain injury: focal injury occurs in a specific location, while diffuse injury occurs over a more widespread area. It is common for both focal and diffuse damage to occur as a result of the same event; many traumatic brain injuries have aspects of both focal and diffuse injury. Focal injuries are commonly associated with an injury in which the head strikes or is struck by an object; diffuse injuries are more often found in acceleration/deceleration injuries, in which the head does not necessarily contact anything, but brain tissue is damaged because tissue types with varying densities accelerate at different rates. In addition to physical trauma, other types of brain injury, such as stroke, can also produce focal and diffuse injuries. There may be primary and secondary brain injury processes. Focal
A focal traumatic injury results from direct mechanical forces (such as occur when the head strikes a windshield in a vehicle accident) and is usually associated with brain tissue damage visible to the naked eye. A common cause of focal injury is penetrating head injury, in which the skull is perforated, as frequently occurs in auto accidents, blows, and gunshot wounds. Focal injuries typically have symptoms that are related to the damaged area of the brain. Stroke can produce focal damage that is associated with signs and symptoms that correspond to the part of the brain that was damaged.
Osilodrostat, sold under the brand name Isturisa, is a medication for the treatment of adults with Cushings disease who either cannot undergo pituitary gland surgery or have undergone the surgery but still have the disease. It is taken by mouth.The most common side effects are adrenal insufficiency, headache, vomiting, nausea, fatigue, and edema (swelling caused by fluid retention).Hypocortisolism (low cortisol levels), QTc prolongation (a heart rhythm condition) and elevations in adrenal hormone precursors (inactive substance converted into a hormone) and androgens (hormone that regulates male characteristics) may also occur in people taking osilodrostat.Osilodrostat was approved for medical use in the European Union in January 2020, and for medical use in the United States in March 2020. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.Osilodrostat is an orally active, nonsteroidal corticosteroid biosynthesis inhibitor which was developed by Novartis for the treatment of Cushings syndrome and pituitary ACTH hypersecretion (a specific subtype of Cushings syndrome). It specifically acts as a potent and selective inhibitor of aldosterone synthase (CYP11B2) and at higher dosages of 11β-hydroxylase (CYP11B1). History
In October 2014, an orphan designation was granted by the European Commission for osilodrostat for the treatment of Cushings syndrome.Osilodrostat was approved for medical use in the European Union in January 2020, and for medical use in the United States in March 2020.Osilodrostats safety and effectiveness for treating Cushings disease among adults was evaluated in a study of 137 adult subjects (about three-quarters women) with a mean age of 41 years.