Neuroscience Clerkship at UH/VA
 

PRIMARY VS SECONDARY INSULTS IN TRAUMATIC BRAIN INJURY

Insults resulting from traumatic brain injury (TBI) are commonly divided into primary and secondary etiologies.

Primary

This is the precipitating injury that results in immediate effects. These include:

Direct trauma to the brain

Subarachnoid hemorrhage

Epidural hematoma

Subdural hematoma

Contusion

Axonal shear injury from accelerating/decelerating


Secondary

These are the systemic and intracranial effects that follow the initial injury. Survival of severe brain injury is dependent on avoiding or minimizing the secondary insults to the brain.

Systemic effects include:

Hypotension/hypertension

Hypoxia

Anemia

CO2 changes

Electrolyte/glucose/acid-base abnormalities

Intracranial effects include:

Ischemia

Edema

Hydrocephalus

Infection

Seizure

Hemorrhage