http://bja.oxfordjournals.org/content/99/1/4
+ Author Affiliations
- *Corresponding author. E-mail: werner@anaesthesie.klinik.uni-mainz.de
Abstract
The knowledge of the pathophysiology after
traumatic head injury is necessary for adequate and patient-oriented
treatment.
As the primary insult, which represents the direct
mechanical damage, cannot be therapeutically influenced, target of the
treatment is the limitation of the secondary damage
(delayed non-mechanical damage). It is influenced by changes in
cerebral
blood flow (hypo- and hyperperfusion), impairment
of cerebrovascular autoregulation, cerebral metabolic dysfunction and
inadequate
cerebral oxygenation. Furthermore, excitotoxic cell
damage and inflammation may lead to apoptotic and necrotic cell death.
Understanding the multidimensional cascade of
secondary brain injury offers differentiated therapeutic options.
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