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  1. Roth, Phyllis RN, MSN
  2. Farls, Kathleen RN, BSN


Approximately 7 million people in the United States each year experience traumatic brain injury, the leading cause of death from injury in this country. 1 The initial traumatic event, often described as the primary injury, and the pathophysiologic sequelae, the secondary injury, are the themes of this article. Primary injuries to the extracranial and intracranial structures will be discussed, as well as the secondary injuries that occur minutes to days after the initial insult. It is critical that the bedside nurse clinician understand these concepts to anticipate potential complications and plan appropriate interventions with the multidisciplinary team. The goal of these interventions is to prevent the devastating effects of secondary injury.