Research
No medication to halt the progression of secondary injury exists, but the variety of pathological events presents opportunities to find treatments that interfere with the damage processes. Neuroprotection, methods to halt or mitigate secondary injury, have been the subject of great interest for their ability to limit the damage that follows TBI. However, clinical trials to test agents that could halt these cellular mechanisms have met largely with failure. For example, interest existed in hypothermia, cooling the injured brain to limit TBI damage, but clinical trials showed that it is not useful in the treatment of TBI. In addition, drugs such as NMDA receptor antagonists to halt neurochemical cascades such as excitotoxicity showed promise in animal trials but failed in clinical trials. These failures could be due to factors including faults in the trials' design or in the insufficiency of a single agent to prevent the array of injury processes involved in secondary injury. Recent research has gone into monitoring brain metabolism for ischaemia, in particular the parameters of glucose, glycerol, and glutamate through microdialysis.
Developments in technologies may provide doctors with valuable medical information. For example, work has been done to design a device to monitor oxygenation that could be attached to a probe placed into the brain—such probes are currently used to monitor ICP. Research is also planned to clarify factors correlated to outcome in TBI and to determine in which cases it is best to perform CT scans and surgical procedures.
Hyperbaric oxygen therapy (HBO) has been evaluated as an adjunctive treatment following TBI, concluding a Cochrane review stating that its use could not be justified. HBO for TBI has remained controversial as studies have looked for improvement mechanisms, and further evidence shows that it may have potential as a treatment.
Read more about this topic: Traumatic Brain Injury
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