How does hyperglycemia influence TBI outcomes?

How does hyperglycemia influence TBI outcomes?

• A. Improves outcomes
• B. Worsens outcomes and increases edema
• C. No effect
• D. Decreases edema

Answer: (B)

Hyperglycemia after traumatic brain injury worsens outcomes by promoting edema and secondary brain injury through metabolic and inflammatory pathways. When the brain is injured, energy metabolism is already compromised, and excess glucose tends to be driven into anaerobic pathways, producing lactate and hydrogen ions that cause acidosis. This acidosis worsens neuronal injury and impairs mitochondrial function, while high glucose also fuels inflammation and oxidative stress and disrupts the blood-brain barrier. The result is increased brain swelling (edema), higher intracranial pressure, and larger overall injury, all of which correlate with poorer functional outcomes and higher mortality. In practice, avoiding sustained hyperglycemia is beneficial, though care must be taken to prevent hypoglycemia, which also harms the injured brain.

Hyperglycemia after traumatic brain injury worsens outcomes by promoting edema and secondary brain injury through metabolic and inflammatory pathways. When the brain is injured, energy metabolism is already compromised, and excess glucose tends to be driven into anaerobic pathways, producing lactate and hydrogen ions that cause acidosis. This acidosis worsens neuronal injury and impairs mitochondrial function, while high glucose also fuels inflammation and oxidative stress and disrupts the blood-brain barrier. The result is increased brain swelling (edema), higher intracranial pressure, and larger overall injury, all of which correlate with poorer functional outcomes and higher mortality. In practice, avoiding sustained hyperglycemia is beneficial, though care must be taken to prevent hypoglycemia, which also harms the injured brain.