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Secondary Energy Failure

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Secondary Energy Failure (Approx. 8-16 hours later) Decrease in high-energy phosphates impairs the Na+ / K+ pump and results in an acute influx of Na+, Cl-, and water Causes cell lysis & cytotoxic edema, and results in excessive release of excitatory neurotransmitters like glutamate (due to these receptors being permeable to Na+), as well as the generation of free radicals This triggers an “excitotoxic cascade”: Influx of Ca2+ & thus release of Ca2+ from intracellular stores, which activates enzymes to stimulate the production of excessive amounts of nitric oxide (results in NO neurotoxicity), which triggers the generation of free radicals & degradation of cellular lipids and proteins (and causes injury to the mitochondria) Results in neuronal

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