Early complementary acupuncture improves the clinical prognosis of traumatic brain edema

Abstract

Background: Traumatic brain edema occurs commonly brain injury, and most manifests as pericontusional edema of brain contusions. On the basis of evidence-based medicine, apart from recommending craniotomy and mannitol, there are few particularly effective measures to prevent and treat traumatic brain edema. It is uncertain whether an early complementary acupuncture treatment would improve long-term outcomes of patients with traumatic brain edema. The aim of this study is to assess the efficacy and the safety of early complementary acupuncture for patients with traumatic brain edema.Methods: This study is an actively accruing, single-center, single-blinded, 2-arm, randomized controlled trial. Patients with traumatic brain injury, a Glasgow Coma Scale score of 6∼12, and brain edema on computed tomography scan will be divided into 2 groups on the basis of stratified block randomization. All patients will receive conventional treatment, and the study group will undergo additional acupuncture therapy (start within 72 hours after the injury) once a day for 28 days. The primary outcome is the dichotomized Glasgow Outcome Score at 6 months and 12 months after injury, and the secondary outcomes are the Glasgow Coma Scale, the volume of traumatic brain edema, the serum levels of C-reactive protein and interleukin-6, and the Modified Barthel Index.Discussion: This study will provide data regarding the efficacy of early complementary acupuncture for traumatic brain edema. If the study yields positive results, its findings may offer insights into a valuable complementary option of acupuncture for traumatic brain edema that could provide pilot evidence for large, randomized, controlled trials.Trial registration: This trial has been published in the Chinese Clinical Trial Register, http://www.chictr.org.cn/edit.aspx?pid= 141208&htm=4 (Identifier: ChiCTR2100053794, registered on December 3, 2021).Abbreviations: CRFs = case report forms, CRP = C-reactive protein, CT = computed tomography, GCS = Glasgow Coma Scale, GOS = Glasgow Outcome Score, ICP = intracranial pressure, IL-6 = interleukin-6, MBI = Modified Barthel Index, RCT = randomized clinical trial, TBE = traumatic brain edema, TBI = traumatic brain injury.

Melatonin as a Potential Neuroprotectant: Mechanisms in Subarachnoid Hemorrhage-Induced Early Brain Injury

“…Pragmatic therapeutic strategies for brain edema such as acupuncture, osmotherapy, non-peptide vasopressin receptor antagonist, and calcium channel blockers are used in clinical practice (Rowland et al, 2019;Corry et al, 2020;Hinson et al, 2020;Guo et al, 2022). Although the above-mentioned treatment approaches have been well-studied and display partial protective effects in attenuating cerebral edema, a single therapy capable of inhibiting cerebral edema is yet to be found due to the complex mechanisms involved.…”