Comparison of Mean Glasgow Outcome Score in Patients with Traumatic Brain Injury after Magnesium Sulphate Therapy and Placebo. A Prospective Study of Shaikh Zayed Hospital Lahore
Objective: We evaluated the effectiveness of magnesium sulphate treatment for the management and outcome of TBI.
Material and Methods: The prospective cases (n = 112) of TBI were included from Department of Neurosurgery, Shaikh Zayed Hospital, Lahore. Patients were split into two groups. Magnesium sulphate treatment group (n = 56) and placebo group (n = 56). Detailed history of patients was taken along with comprehensive examinations with CT scans.56 TBI patients were given standard treatment plus magnesium sulphate and remaining 56 patients received just standard treatment.
Results: Mean age of the magnesium supplement therapy group was 36.83 ± 13.45 years while in the placebo group was 33.64 ± 12.88 years). Majority 28 (67.9%) were male in the magnesium sulphate group while 37 (66.1%) were in the placebo group. Mean duration passed between hospital presentation and traumatic brain injury was 4.98 ± 2.32 hours in the magnesium sulphate group while it was 5.05 ± 2.48 in the placebo group. Mean Glasgow outcome score was 3.57 ± 1.33 in the magnesium sulphate group while 2.78 ± 1.23 in the placebo group and this difference was statistically significant.
Conclusion: There is significant improvement in GOS after magnesium sulphate therapy in patients with traumatic brain injury versus placebo group as noted in the results.
2. Marehbian J, Muehlschlegel S, Edlow BL, Hinson HE, Hwang DY. Medical Management of the severe traumatic brain injury patient. Neurocrit Care, 2017; 26 (3): 12017-028.
3. Li M, Zhao Z, Yu G, Zhang J. Epidemiology of traumatic brain injury over the world: A Systematic Review .Gen Med (Los Angel), 2016; 4 (5): 271-284.
4. Salehpour F, Shakeri M, Ahmadvand A, Vafaee R, Jafari R, Safaiyan A. Magnesium Sulfate effect on the clinical course and GCS of patients with a severe diffuse axonal injury. JPS 2012; 3 (4): 70-75.
5. Kochanek PM, Jackson TC, Ferguson NM, Carlson SW, Simon DW, Brockman EC, et al. Emerging therapies in traumatic brain injury. J Semin Neurol. 2015; 35 (1): 83-100.
6. Busingye DS, Turner RJ, Vink R. Combined Magnesium/Polyethylene Glycol Facilitates the Neuroprotective effects of magnesium in traumatic brain injury at a reduced magnesium dose. CNS Neuroscience & Therapeutics, 2016; 22: 854–859.
7. Vink R. Magnesium in the CNS: recent advances and developments. Magnesium Research, 2016; 29 (3): 95-101.
8. Zhao L, Wang W, Zhong J, Li YY, Cheng YZ, Su Z,
et al. The effects of magnesium sulfate therapy after severe diffuse axonal injury. Ther Clin Risk Manag. 2016; 12: 1481–1486.
9. Li W, Bai YA, Li YJ, Liu KG, Wang MD, Xu GZ, Shang HL, Li YF. Magnesium sulfate for acute traumatic brain injury. J Craniofac Surg. 2015; 26 (2): 393-8.
10. Can Magnesium Sulphate Prevent Cerebral Ischemic Injury? An Experimental Study and Neuroradiological Evidence. J Neurol Sci Turk. 2013; 30 (1): 030-039.
11. Sharp DJ, Beckmann CF, Greenwood R, Kinnunen KM, Bonnelle V, De Boissezon X, Powell JH, Counsell SJ, Patel MC, Leech R. Default mode network functional and structural connectivity after traumatic brain injury. Brain. 2011 Aug 1; 134 (8): 2233-47.
12. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States. emergency department visits, hospitalizations, and deaths, 2010: 2010.
13. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States. emergency department visits, hospitalizations, and deaths, 2010: 2010.
14. Frieden T, Collins F. Report to congress on traumatic brain injury in the United States: understanding the public health problem among current and former military personnel. NIH, DoD, VA Leadership Panel: CDC. 2013.
15. Temkin NR, Anderson GD, Winn HR Magnesium sulfate for neuroprotection after traumatic brain injury: a randomised controlled trial. Lancet Neurol. 2007; 6: 29-38.
16. Heath DL, Vink R. Optimization of magnesium therapy following severe diffuse axonal brain injury in rats. J Pharmacol Exp Ther. 1999; 288: 1311-6.
17. McKee JA, Brewer RP, Macy GE, Phillips-Bute B, Campbell KA, Borel CO. Analysis of the brain bioavailability of peripherally administered magnesium sulfate: A study in humans with acute brain injury undergoing prolonged induced hypermagnesemia. Crit Care Med. 2005; 33: 661-6.
18. Habgood MD, Bye N, Dziegielewska KM, Ek CJ, Lane MA, Potter A. Changes in blood-brain barrier permeability to large and small molecules following traumatic brain injury in mice. Eur J Neurosci. 2007; 25: 231-8.
19. Heath DL, Vink R. Delayed therapy with magnesium up to 24 h following traumatic brain injury improves motor outcome. J Neurosurg. 1999; 90: 504-9.
20. Miller JW, D. Ambrosio R. When basic research does not translate to the bedside lessons from the Magnesium Brain Trauma study. Epilepsy Curr. 2007; 7: 133-5.
21. Scholler K, Zausinger S, Baethmann A, Schmid Elsaesser R. Neuroprotection in ischemic stroke-combination drug therapy and mild hypothermia in a rat model of permanent focal cerebral ischemia. Brain Res. 2004; 1023: 272-8.
22. Kwon BK, Roy J, Lee JH, Okon EB, Zhang H, Marx JC, Magnesium chloride in a polyethylene glycol for mulation as a neuroprotective therapy for acute spinal cord injury: preclinical refinement and optimization. J Neurotrauma, 2009; 24: 24.
23. Iotti S, Malucelli E. In vivo assessment of Mg in human brain and skeletal muscle b P-MRS. Magnes Res. 2008; 21: 157-62.
24. Li W, Bai YA, Li YJ, Liu KG, Wang MD, Xu GZ, Shang HL, Li YF. Magnesium sulfate for acute traumatic brain injury. Journal of Craniofacial Surgery, 2015 Mar. 1; 26 (2): 393-8.
25. Shakeri M, Salehpour F, Ahmadvand A, Jafari R, Safaiyan A, Meshkini A. Effects of magnesium sulfate on the clinical course and GCS of patients with a severe diffuse axonal injury. Journal of Injury and Violence Research, 2012 Nov; 4 (3 Suppl. 1).
26. Lyons MW, Blackshaw WJ. Does magnesium sulfate have a role in the management of severe traumatic brain injury in civilian and military populations? A systematic review and meta-analysis. Journal of the Royal Army Medical Corps. 2018 Apr. 17: JRAMC-2018.
27. Masel BE, DeWitt DS. Traumatic brain injury: a disease process, not an event. Journal of Neurotrauma, 2010 Aug. 1; 27 (8): 1529-40.
Copyright (c) 2020 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.