Abstract
Traumatic cerebral vascular injury (TCVI) is a frequent, if not universal, feature after traumatic brain injury (TBI). Because multiple pharmacologic and nonpharmacologic therapies promote vascular health, TCVI is an attractive target for therapeutic intervention after TBI. The cerebral microvasculature is a component of the neurovascular unit (NVU) coupling neuronal metabolism with local cerebral blood flow. The NVU participates in the pathogenesis of TBI, either directly from physical trauma or as part of the cascade of secondary injury that occurs after TBI. Pathologically, there is extensive microvascular injury in humans and experimental animals, identified with either conventional light microscopy or ultrastructural examination. Noninvasive, physiologic measures of cerebral microvascular function show dysfunction after TBI in humans and experimental animal models of TBI. These include imaging sequences, transcranial Doppler, and near infrared spectroscopy. Understanding the pathophysiology of TCVI, a relatively understudied component of TBI, has promise for the development of novel therapies for TBI.
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