ABSTRACT
The outcome after traumatic brain injury (TBI) has improved during the past three
decades. This has mainly been accomplished through improved neurointensive care. Neuroprotective
drugs have been disappointing in past clinical trials, and TBI remains one of few
common severe illnesses completely without specific pharmacological therapy. One of
the biggest challenges for brain trauma research is finding a way to translate preclinical
results to the clinical care of the patients. It is hoped that advances in the understanding
of basic molecular injury mechanisms and the possible association of genetic profile
with outcome after TBI will soon provide better opportunities for drug development.
In this review, we summarize some of the pathophysiological pathways targeted for
pharmacological intervention in TBI patients. In order to achieve therapeutic success
in the future, the advancement in basic science must develop in concert with standardized
methods for monitoring and analyzing neurointensive care data between different trauma
centers. The European collaboration BrainIT is a first step in this direction. With
this type of approach, neuroprotective drugs may also prove to be beneficial in the
clinical setting.
KEYWORDS
Apoptosis - necrosis - neuroprotection - neurointensive care - traumatic brain injury