Well known and must-read paper on the use of steroid cover in TBI patients. It is by far the largest trial on this subject and still forms the basis for today’s recommendations that steroids not be used in this patient group. Published in the Lancet 2005. “The risk of death was higher in the corticosteroid… Continue reading CRASH Trial on Steroids and TBI
ProTECT III, the results of which were published alongside those of the SYNAPSE-trial in the December 25 2014 issue of NEJM, demonstrates no patient-important advantage conferred by the administration of progesterone (albeit very early in this particular study) to TBI patients. “This clinical trial did not show a benefit of progesterone over placebo in the… Continue reading ProTECT III -Progesterone in TBI, Another Step Towards Futility
A Clinical Trial of Progesterone for Severe Traumatic Brain Injury, by Brett E. Skolnick et al, 2014. New England Journal of Medicine. “Primary and secondary efficacy analyses showed no clinical benefit of progesterone in patients with severe TBI. These data stand in contrast to the robust preclinical data and results of early single-center trials that provided… Continue reading Progesterone in TBI, Results from the SYNAPSE-trial
Review by the Cochrane Injuries Group (2012, Junpeng et al) shows some promise concerning the use of progesterone in TBI. “Current clinical evidence from three small RCTs indicates progesterone may improve the neurologic outcome of patients suffering TBI. This evidence is still insufficient and further multicentre randomised controlled trials are required”
Important trial dealing with the contentious issue of decompressive craniectomy for diffuse traumatic brain injury. Cooper et al. New England Journal of Medicine 2011. “In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with… Continue reading DECRA trial – Decompressive Craniectomy in Diffuse Traumatic Brain Injury
Acute and delayed mild coagulopathy are related to outcome in patients with isolated traumatic brain injury. Greuters et al. Crit Care. 2011.
Relationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury. Stein et al. J Neurosurg. 2010.
Prognostic value of computerized tomography scan characteristics in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007. Maas et al. http://www.ncbi.nlm.nih.gov/pubmed/17375995
Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007. McHugh et al.
Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet. 2008, Polderman et al. http://www.ncbi.nlm.nih.gov/pubmed/18539227