• David A Hovda.
• Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.
• Prog Neurol Surg. 2014 Jan 1; 28: 28-37.

AbstractThe following report reviews our current understanding of the neurobiological response to concussion which is often referred to as mild traumatic brain injury. The historical accomplishments to reveal the brain's response to this injury are discussed along with the neurochemical and metabolic cascade that results in an energy crisis. The massive ionic flux induced by cerebral concussion is discussed as it pertains to primarily potassium and calcium. The ensuing metabolic demands placed on cells exposed to this ionic flux is discussed as it relates to an injury-induced diaschisis. As this cascade produces neuronal dysfunction and corresponding deficits, it also results in a state of vulnerability to secondary insults and long-term neurological problems. While experimental studies are the primary focus of this report, relevant human observations are discussed and put into context. It is now clear that cerebral concussion is not a benign event. It carries with it neuroscientific consequences that result in symptoms and an increase in risk for many other challenges to the central nervous system.© 2014 S. Karger AG, Basel.

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