Cook Aaron M, Michas Morgan, Robbins Blake
Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA.
UK HealthCare Pharmacy Services, Lexington, KY, USA.
CNS Drugs. 2025 May;39(5):473-484. doi: 10.1007/s40263-025-01173-9. Epub 2025 Mar 14.
Traumatic brain injury (TBI) is a prevalent cause of morbidity and mortality worldwide. A focus on neuroprotective agents to prevent the secondary injury cascade that follows moderate-to-severe TBI has informed the field greatly but has not yielded any viable therapeutic options to date. New strategies and pharmacotherapy options for neuroprotection continue to be evaluated, including tranexamic acid, progesterone, cerebrolysin, cyclosporin A, citicholine, memantine, and lactate. Biomarkers of injury that can aid in diagnosis and prognosis have also been elucidated and are incrementally being used in clinical practice. The spectrum of TBI severity has also gained increasing attention as it relates to mild TBI or concussion, blast injury, and subacute or chronic subdural hematomas. In this review, we review the pathophysiology, recent clinical trials, and future directions for acute TBI.
创伤性脑损伤（TBI）是全球发病和死亡的常见原因。专注于神经保护剂以预防中重度TBI后的继发性损伤级联反应，极大地推动了该领域的发展，但迄今为止尚未产生任何可行的治疗方案。神经保护的新策略和药物治疗方案仍在持续评估中，包括氨甲环酸、孕酮、脑蛋白水解物、环孢素A、胞磷胆碱、美金刚和乳酸盐。有助于诊断和预后的损伤生物标志物也已得到阐明，并逐渐应用于临床实践。TBI严重程度谱，如与轻度TBI或脑震荡、爆炸伤以及亚急性或慢性硬膜下血肿的关系，也越来越受到关注。在本综述中，我们回顾了急性TBI的病理生理学、近期临床试验及未来发展方向。
