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Could standard treatment for traumatic brain injury be wrong?
Date:6/3/2009

Traumatic brain injury not heart disease, stroke or cancer is the number one cause of death and disability in people under 45. Each year, some 1.5 million Americans, including soldiers, athletes, the elderly and children, sustain head injuries, and nearly half of them will be hospitalized and treated in an emergency room or intensive care unit.

But what if they are treated incorrectly?

The Brain Injury Research Center (BIRC) in the UCLA Department of Neurosurgery has been awarded a $4.2 million grant from the National Institutes of Health to research new ways to heal the brain after a traumatic brain injury, or TBI. Specifically, researchers will be looking at how to best feed the brain the nutrients it needs to optimize recovery.

The standard thinking for many years has been that after a TBI, the brain lies in a docile state or coma and thus requires very little energy. But research from the BIRC now shows that the brain's response to trauma requires enormous amounts of energy.

"Many patients with a traumatic brain injury exhibit hyperglycemia high blood sugar by the time they arrive in the ER," said David Hovda, professor of neurosurgery and director of the BIRC. "So the standard protocol was to give the patient insulin to tightly control the levels of glucose that would take them to normal. For many regions of the injured brain, this may be the wrong thing to do."

In fact, the brain needs fuel to initiate the healing process and not just glucose, Hovda suspects. Because they have found that the way glucose is used by the brain changes after a TBI, researchers believe other naturally used compounds, including pyruvate, beta-hydroxybutyrate, lactate and ketones, should be considered in treatment. Hovda and his colleagues think that each of these fuels may serve a different purpose, depending on the severity of the injury and whether the injured individual is an adult or adolescent. The goal, ther
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Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles
Source:Eurekalert

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