Considerable strides in medical interventions during the acute phase of traumatic brain injury (TBI) have brought improved overall survival rates. However, following TBI, people often face ongoing, persistent and debilitating long-term complications. Here, we review the recent literature to propose possible mechanisms that lead from TBI to long-term complications, focusing particularly on the involvement of a compromised blood–brain barrier (BBB). We discuss evidence for the role of spreading depolarization as a key pathological mechanism associated with microvascular dysfunction and the transformation of astrocytes to an inflammatory phenotype. Finally, we summarize new predictive and diagnostic biomarkers and explore potential therapeutic targets for treating long-term complications of TBI.

创伤性脑损伤 (TBI) 急性期医疗干预措施的显着进步提高了总体生存率。然而，创伤性脑损伤后，人们常常面临持续、持续和使人衰弱的长期并发症。在这里，我们回顾了最近的文献，提出了导致 TBI 导致长期并发症的可能机制，特别关注血脑屏障 (BBB) 受损的参与。我们讨论了扩散去极化作为与微血管功能障碍和星形胶质细胞向炎症表型转化相关的关键病理机制的作用的证据。最后，我们总结了新的预测和诊断生物标志物，并探索治疗 TBI 长期并发症的潜在治疗靶点。