Evolving treatment strategies for TBI management
Over the past 30 years there has been a significant reduction in
mortality following severe TBI together with improved outcome. This has been
largely due to the use of evidence-based protocols emphasizing the correction
of parameters implicated in secondary brain injury. The main parameters are
cerebral blood flow, cerebral oxygenation and management of co-morbidities.
Neuroinflammation is a well-established secondary injury mechanism following
TBI.
Inspired by success in Parkinson’s and other neurodegenerative diseases,
stem cell based therapy is believed to provide biobridges, can stabilize
blood-brain barrier, reduce the oxidative stress and provide immunomodulation
and neuroprotection. Hyperbaric oxygen may alleviate secondary insult in TBI
through the modulation of the inflammatory response. Animal studies showed that
hyperbaric oxygen improves neuroplasticity, reduce the inflammatory markers and
neuronal apoptosis following TBI.
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