Key messages

• Brain injury is classified as focal (intracerebral hemorrhage, subdural or epidural hematoma) or diffuse (diffuse axonal injury). Focal injuries are more amenable to surgical intervention.

• Primary injury occurs at the moment of injury and includes contusion, laceration, diffuse axonal injury, and epidural and subdural hemorrhage.

• Secondary injuries are due to secondary processes, such as those caused by excitatory amino acids, free radicals, and nitric oxide, or secondary insults, such as hypotension, hypoxia, hyponatremia, and hypothermia.

• Maintenance of cerebral perfusion pressure is important in maximizing the probability of a favorable outcome following traumatic brain injury.

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