Why and how to control secondary insults after brain injury

Abstract

After a primary major brain injury, secondary ischemic insults to the brain may occur and worsen neurological outcome and final survival. The injured brain is more vulnerable to a secondary insult. These events may occur within the first minutes, hours or days following the primary brain injury. Protocols aiming at detecting and treating early these events, especially hypoxia and hypotension, can improve the prognosis of brain-injured patients. Here, we will review the so called “systemic secondary insults to the brain” as well as potential therapeutic approaches applicable in the emergency setting.