Which of the following is a systemic factor commonly contributing to secondary brain injury after TBI?

• A. Fever
• B. Local scalp hematoma
• C. Skull fracture
• D. Drowsiness

Answer: (A)

Fever represents a systemic response that can worsen secondary brain injury after a TBI. When body temperature rises, the brain’s metabolic demands increase, raising oxygen and glucose needs. If blood flow can’t meet this heightened demand, brain tissue becomes more vulnerable to ischemia. Fever also amplifies inflammatory cascades and can disrupt the blood-brain barrier, promoting edema and higher intracranial pressure. This systemic stress compounds the injury and can lead to greater neuronal damage.

Localized scalp hematoma or skull fracture are injuries confined to the head and don’t reflect the body’s global response, while drowsiness is a symptom that signals brain injury rather than a systemic process driving secondary damage.