Answer to Question 1
Inflammatory response: the inflammatory response results in beneficial and detrimental effects related to the roles of various inflammatory mediators and cytokines; results in increased intracranial pressure and impaired cerebral perfusion pressure cause these effects
Oxidative stress: leads to the secondary damage of neurons, glia, and axons
Ischemia: reduced blood flow to the neuronal tissue due to the increased cranial pressure can reduce the delivery of nutrients needed for recovery and decrease the removal of toxic metabolites from the damaged tissue
Hypoxia: this is related to the lack of blood flow and further damage may result due to the lack of oxygen to supply the energetic needs of the recovering damaged tissue
Increased intracranial pressure: the elevated intracranial pressure results in poor tissue perfusion which may lead to secondary damage to the brain tissue
If intracranial pressure can be minimized, tissue perfusion and delivery of nutrients to the sites of damage will help Mr. Walker's recovery. Additionally, if the inflammatory response can be controlled, damage due to oxidative stress and inflammatory cytokines may further hasten his recovery during his hospitalization.
Answer to Question 2
Consistent reflux of gastric contents can severely erode the mucosa of the esophagus, resulting in an esophageal ulcer.
Scar tissue development may also occur, resulting in esophageal stricture and dysphagia.
An additional complication associated with GERD is development of Barrett's esophagus. Barrett's esophagus is characterized by metaplastic changes in esophageal cells, and for a small percentage of individuals may result in esophageal adenocarcinoma.