Microcirculatory disturbance: A new mechanism of brain swelling after traumatic brain injury?

The mechanism of traumatic brain swelling has not been fully studied, and various existing theories lack strong experimental evidence. Through comprehensive analysis of current theories, it was found that microcirculation disturbance may be an important mechanism in the early stage of traumatic brain swelling. Therefore, we hypothesized that in patients with severe brain injury, partial cerebral venous return decreases, and the cerebral blood flow rate decreases. Due to hematoma, high cranial pressure, hypoxia and other factors, the cells in the neurovascular unit express certain factors, further contracting microcirculation blood vessels through pericyte contraction and obstructing blood flow, resulting in unbalanced cerebral circulation intake and outflow. Excessive vascular congestion occurs in brain tissue, which in turn increases cerebral edema and eventual brain swelling. The purpose of this hypothesis is to supplement the shortcomings of current theories and provide new directions and suggestions for future research on traumatic brain swelling.