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Traumatic brain injury (TBI) is a major cause of mortality and morbidity with large indirect and direct costs to society. TBI was the first neurological disease for which progesterone administration was studied. Many animal models have been used to elucidate the mechanism by which progesterone offers neuroprotection following TBI. Several of the studies demonstrated that progesterone reduces post-injury cerebral edema. Now, two randomized, controlled trials have examined the effect of progesterone in patients with moderate-to-severe TBI. Both trials used a Glasgow Coma Scale (GCS) for the selection and stratification of patients.
Skolnick and colleagues enrolled 1195 participants (age range, 16–70) with severe TBI (GCS score ≤8). Patients we…