Evolution of the Neurometabolic Cascade of Traumatic Brain Injury.

Since the original descriptions by Giza and Hovda of the acute neurometabolic cascade of concussion 25 years ago, there has been a broad evolution in the understanding of concussion and other types of traumatic brain injuries (TBI) to include not only acute, neuro, and metabolic aspects of pathophysiology but also the impact and risk of TBI on numerous molecular and cellular processes, neural networks and physiologic systems. This review summarizes research and clinical advancements in the neurometabolic cascade of TBI, recognizing that evolution beyond this postinjury neuronal perspective is key to unlocking improved therapies and reduction of long-term risk.