Which metabolic complication requires monitoring in TBI patients?

• A. Hyperglycemia and dysglycemia
• B. Hypothyroidism
• C. Hyponatremia only
• D. Hyperkalemia

Answer: (A)

In brain injury, keeping the brain’s energy supply stable is crucial. Glucose is the brain’s main fuel, and after severe TBI the body’s glucose handling can become distorted, leading to hyperglycemia or large fluctuations in glucose (dysglycemia). High blood glucose in the acute phase worsens brain injury by promoting lactic acidosis, oxidative stress, inflammation, and edema, all of which can worsen neuronal injury and outcomes. Conversely, hypoglycemia deprives the brain of needed fuel and also harms recovery. Because both too-high glucose and unstable glucose levels consistently relate to poorer neurologic outcomes, monitoring and tightly managing blood glucose and avoiding dysglycemia is a central metabolic priority in TBI care.

Hyponatremia is indeed a common issue after TBI and requires attention, since it can contribute to brain edema and seizures, but it’s one of several metabolic disturbances to watch. Hypothyroidism and hyperkalemia are less immediate or specific problems in the acute TBI setting, so they’re not the primary focus of metabolic monitoring in this context.