Why does a secondary metabolic crisis often follow a mild traumatic brain injury (mTBI) despite initial computed tomography (CT) scans appearing normal?

💡 Explanation

Following mTBI, diffuse axonal injury causes widespread disruption of neuronal ion homeostasis, leading to an energy-dependent restoration process that can precipitate a secondary metabolic crisis because energy demands outstrip supply in the vulnerable post-injury period. Therefore, a delayed metabolic crisis is observed, rather than an immediate event as edema would trigger.

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