Shared neuropathological features of mild traumatic brain injury and anesthesia

Mild traumatic brain injuries are highly prevalent and can produce persistent sequelae, creating substantial personal and societal burdens. Recent evidence suggests that anesthesia administration for extracranial surgeries is both common and potentially problematic following concussive injuries. Despite this concern, few studies have assessed outcomes among concussion patients undergoing surgery, and clinical guidance for this population remains limited. This review examines shared neuropathological features between mild traumatic brain injury and anesthesia to identify potential mechanisms that could underlie poor outcomes following surgery in the setting of concussion. Both mild traumatic brain injury and anesthesia contribute to neuroinflammation and impaired blood-brain barrier function, resulting in neuronal and glial injury. When superimposed on the mechanical injury caused by concussion, these overlapping processes may contribute to secondary injury, delayed recovery, and worse long-term outcomes.