Neuroprotection After Traumatic Brain Injury: Is There any Hope?


Department of Neurology, Kashan University of Medical Sciences, Kashan, Iran



Traumatic brain injury (TBI), whatever its cause, is already
associated usually with disability and death worldwide.[1] The
mechanism of injury in TBI includes primary and secondary
injuries. The primary brain injury usually appears just when
the trauma is occurred. Common mechanisms comprise direct
impact, rapid acceleration/deceleration, penetrating injury, and
shock waves. The damage that results include a combination
of focal contusions and hematomas, as well as shearing of
white matter tracts (diffuse axonal injury) along with cerebral
edema and swelling.[2] While effective in managing the primary
injury to the brain and the skull, these treatment modalities
do not address the complex secondary cascades that occur at
a cellular level following initial injury and greatly affect the
ultimate neurologic outcome.


1. Agrawal S, Branco RG. Neuroprotective measures in children with traumatic brain injury. World J Crit Care Med 2016;5:36‑46.
2. Management of Acute Severe Traumatic Brain Injury. Available from:‑of‑acute‑severe‑ traumatic‑brain‑injury. [Last updated on 2017 Dec 20].
3. Chakraborty S, Skolnick B, Narayan RK. Neuroprotection trials in traumatic brain injury. Curr Neurol Neurosci Rep 2016;16:29.
4. Stocchetti N, Taccone FS, Citerio G, Pepe PE, Le Roux PD, Oddo M, et al. Neuroprotection in acute brain injury: An up‑to‑date review. Crit Care 2015;19:186.
5. Hawryluk GW, Bullock MR. Past, present, and future of traumatic brain injury research. Neurosurg Clin N Am 2016;27:375‑96.
6. Zoerle T, Carbonara M, Zanier ER, Ortolano F, Bertani G, Magnoni S, et al. Rethinking neuroprotection in severe traumatic brain injury: Toward bedside neuroprotection. Front Neurol 2017;8:354.
7. Nichol A, French C, Little L, Haddad S, Presneill J, Arabi Y, et al. Erythropoietin in traumatic brain injury (EPO‑TBI): A double‑blind randomised controlled trial. Lancet 2015;386:2499‑506.