ABSTRACT
Traumatic brain injury (TBI) is a silent global epidemic and is a major cause of morbidity and mortality. TBI is of two types: primary injury and secondary injury. Primary injury occurs within the first few milliseconds and consists of the biomechanical effects of the forces applied to the brain. The secondary injury takes a few minutes, hours, or days to develop after the trauma. Static and dynamic mechanical forces in road traffic accidents lead to primary injury of the brain. Secondary injury is mainly due to hypoxia or hypotension. Coagulation disorder occurs commonly after TBI. Diuretics have been used to reduce the volume of intracellular and extracellular fluid compartments of the brain. Hypothermia reduces cerebral metabolism during stress, reduces excitatory neurotransmitters release, attenuates blood–brain barrier (BBB) permeability, and has been used for brain protection in patients with TBI for decades.
