Aim: The complex pathobiology of traumatic brain injury (TBI) offers numerous targets for potential neuroprotective agents. We evaluate the clinical benefit after creatine (Cr) administration in children and adolescents Methods: A prospective, randomized, comparative, open-labelled pilot study of the possible neuroprotective effect of Cr was carried out on 39 children and adolescents, aged between 1 and 18 years of age, with TBI. The Cr was administered for 6 months, at a dose of 0.4 g/kg in an oral suspension form every day. For categorical variables, we used the Chi-square test to identify differences between controls and cases. Statistical significance was defined as a p-value < 0.05 and not statistically significant if p-value > 0.1. Results: The administration of Cr to children and adolescents with TBI improved results in several parameters, including duration of post traumatic amnesia (PTA), duration of intubation, intensive care unit stay. Significant improvement was recorded in the categories of headache (p < 0.001), dizziness (p = 0.005) and fatigue (p < 0.001), aspects in all patients. No side effects were seen due to Cr administration. Conclusion: More specific examinations including brain spectroscopy for in vivo evaluation of Cr can be done, in order to draw conclusions for the optimal duration and manner of Cr supply, as well as its possible role for the prevention of TBI complications, in double blind studies.

Background:The most common cause of death and disability after severe trauma in childhood is traumatic brain injury (TBI). Of all trauma deaths, 25% are caused by head injury. Objectives:The complex pathobiology of traumatic brain injury (TBI) offers numerous targets for potential neuroprotective agents. We evaluate the clinical benefit after creatine administration in children and adolescents. Methods:A prospective, randomized, comparative, open -labeled pilot study of the possible neuroprotective effect of creatine was carried out on 39 children and adolescents, aged between one to eighteen years old, with (TBI). The creatine was administered for 6 months at a dose of 0.4gr/kg in an oral suspension form every day. For categorical variables, we used the χ² test (Chi-square test) to identify differences between controls and cases. Statistical significance was defined as a p-value<0.05 and not statistically significant if p-value >0.1. Results:The administration of creatine to children and adolescents with TBI improved results in several parameters, including duration of post-traumatic amnesia (PTA), duration of intubation, intensive care unit stay. Significant improvement was recorded in the categories of dysarthria (p<0.001) and lingual problems of understanding (p<0.001) aspects in all patients. No side effects were seen due to creatine administration. Conclusions:More specific examinations for in vivo evaluation of creatine must be performed, in order to draw conclusions for the optimal duration and manner of creatine supply, as well as its possible role for the prevention of TBI complications, in double blind studies.

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