Promising strategies to minimize secondary brain injury after head trauma.

OBJECTIVE To review novel therapeutic approaches in the treatment of severe traumatic brain injury. DESIGN Eighty-three studies were reviewed specific to the treatment of traumatic brain injury, in either experimental models or in patients. CONCLUSION Four therapeutic strategies appear to be the most promising approaches currently in clinical trials for severe traumatic brain injury: a) the novel pharmacologic agent dexanabinol; b) hypertonic saline; c) mild hypothermia; and d) decompressive craniectomy. Each of these therapies share the common feature of targeting multiple mechanisms, suggesting this may be an important factor to the development of a successful approach to severe traumatic brain injury.