Table 1. Time Course and Mechanisms of Secondary Insults in Traumatic Brain Injury.

Secondary Insult	Early Causes	Delayed Causes
Hypoxemia	Aspiration Apnea Pneumothorax Pulmonary Contusion Endobronchial Intubation Neurogenic Pulmonary Edema	Adult Respiratory Distress Syndrome Ventilator Acquired Pneumonia Transfusion Related Acute Lung Injury Pulmonary Embolism
Hypotension	Associated High Spinal Cord Injury Long Bone Fracture Thoracic/Abdominal bleeding	Shock Sepsis
Hypercarbia	Apnea Brainstem Injury Inadequate Ventilation	Iatrogenic (opioids) Pneumonia
Hypocarbia	Unwanted Hyperventilation	Unwanted hyperventilation
Hyperglycemia	Stress	Persistent/New onset
Seizures	Electrolyte Abnormalities Hypoglycemia	Syndrome of Inappropriate Antidiuretic Hormone
Vasospasm	-	In patients with traumatic subarachnoid hemorrhage
Intracranial Hypertension	Mass effect of hematoma Herniation	Cerebral edema