Improving Treatments for Severe Brain Injury

Research on the brain's blood flow might lead to improved recovery from severe head trauma.

"Traumatic injuries are the leading cause of death in persons ages 1 to 45," says Dr. Claudia Robertson, program director for the study at Baylor College of Medicine and Ben Taub General Hospital. "In more than half of these deaths, head injury is the leading factor."

Each year, nearly 2 million Americans require medical attention for a brain injury. Of those injured, nearly 74,000 will have a long-term disability, and another 75,000 will die.

Through a study funded by the National Institutes of Health, a diverse team of researchers is looking for new treatments to improve the long-term outcome of head injury patients.

"One of the problems with severe head injury is that the blood flow to the brain is lower than it should be," Dr. Robertson says. "Blood flow supplies the nutrients the brain needs to survive."

This reduced blood flow can cause additional damage to the already injured brain.

As part of the five-year study, researchers will use a new technique to identify patients at greatest risk of additional brain injury. The technique, trans-cranial Doppler, uses an ultrasound of the brain's major blood vessels to reveal decreased blood flow.

"Patients with impaired flow will be given standard treatments to increase their blood pressure," says Dr. Alex Valadka, a Baylor neurosurgeon involved in the study. "Although increasing the blood pressure can reduce additional brain injury, it causes an increased risk of lung problems. The Doppler will help us determine who can benefit most from increased blood pressure treatments."

A second part of the study involves the use of an amino acid, L-arginine, to improve blood flow.

"L-arginine is normally present in the body and metabolizes into nitric oxide, which dilates blood vessels and regulates blood flow," Dr. Robertson says. "Some of the patients identified with impaired blood flow will also be given this treatment."

Over five years, the group will test the new techniques on 300 patients.

- KATHY MAJOR

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©2006 Texas Medical Center

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