If a boxer sustains a blow causing rotational acceleration of the head, which consequence most directly initiates a cascade leading to metabolic crisis during a concussion?

💡 Explanation

Shear strain from rotational acceleration causes diffuse axonal injury, because it deforms axons, disrupting ion channel function and leading to excitotoxicity. Therefore, axonal injury starts the metabolic crisis, rather than direct vascular compression or skull fracture propagation, which are secondary effects.

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