Review of Medications That Reduce Neurological Deficits in Patients With Traumatic Brain Injury

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Medicine

Background:

• Traumatic brain injury (TBI) is a major global cause of death and disability.
• Effective long-term pharmacological treatments for neurological recovery remain elusive.
• Understanding past and present pharmacotherapy is crucial for future TBI treatment strategies.

Purpose of the Study:

• To review current evidence on medications for reducing neurological deficits after TBI.
• To identify emerging therapeutic avenues for neural restoration.
• To guide future research and clinical practice in TBI pharmacotherapy.

Main Methods:

• Comprehensive literature search of MEDLINE, Embase, and ClinicalTrials.gov up to May 2025.
• Inclusion of English-language human trials, meta-analyses, and translational research.
• Quality appraisal using GRADE and Cochrane risk-of-bias tools, with thematic summarization.

Main Results:

• Strong evidence supports early tranexamic acid, nimodipine for subarachnoid hemorrhage, and short-term anticonvulsants for seizure prevention.
• Adjunctive therapies like statins, beta-blockers, and SSRIs show potential for vascular, inflammatory, and cognitive benefits.
• Emerging agents (minocycline, anakinra, cyclosporine A, N-acetylcysteine) show promise in Phase II studies, aided by advances in biomarkers and adaptive trials.

Conclusions:

• TBI pharmacotherapy is evolving from symptom management towards neurorestoration.
• Integrating biomarkers, cost-effective treatments, and personalized medicine is key for improved TBI recovery.
• Continued research holds significant promise for reducing TBI-related disability.