EFFECT OF CEREBROPROTEIN HYDROLYSATE WITH CITICOLINE VERSUS CITICOLINE ALONE IN THE INITIAL MANAGEMENT OF HEAD INJURY AND ITS CLINICAL OUTCOME ‚??A PROSPECTIVE RANDOMISED COMPARATIVE STUDY‚?Ě

Abstract

Varadaraju D. N1, Ananthakishan2

BACKGROUND
Traumatic brain injury is an important cause of morbidity. It also represents the most frequent reason for neurological illness after headache. Compared with other types of brain insult, traumatic brain injury produces more diffuse injury causing more cognitive and neuropsychiatric disturbances. Various drugs have been used in an attempt to improve the clinical outcome, citicoline and Cerebrolysin hydrolysate have been used to improve the clinical outcome in traumatic brain injury. The evidence thus far has been conflicting with reports in favour and against the use of these drugs in the clinical benefit of the patients with traumatic brain injury. We attempt to determine the benefits and advantages of using these drugs in the management of traumatic brain injury.
MATERIALS AND METHODS
This is a prospective study comprising 60 patients of head injury admitted in the Department of Neurosurgery at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The purpose of the current study is to evaluate the effect of cerebroprotein hydrolysate with citicoline compared to citicoline alone in the initial management of head injury and its clinical outcome and to assess the improvement.
RESULTS
Sixty patients with head injury were recruited and divided into group A and group B randomly. The mean age was 43.5 years with 43 male patients and 17 female patients. The GCS at admission of 27 patients was mild head injury and of 33 patients was moderate head injury. Group A had 13 patients with mild head injury and 17 patients with moderate head injury. Group B had 14 patients with mild and 16 patients with moderate head injury at the time of admission. The GCS was assessed at 1 week and 3 weeks. On assessing the patients at 1 week, group A had 14 patients with mild head injury and 16 patients with moderate head injury, whereas group B had 14 patients with mild and 16 patients with moderate head injury. The extended Glasgow Outcome Scale (GOSE) was assessed after 6 months in which group A had fifteen patients with a GOSE score of 8, 10 patients with a score of 7 and 2 patients with a score of 6. Whereas, the group B had 10 patients with a GOSE score of 8, 12 patients with a score of 7 and 4 patients had a score of 6.
CONCLUSION
The results suggest a beneficial effect of Cerebrolysin infusion in patients with mild or moderate head injury during the acute phase. This magnitude in terms of GOS improvement certainly is valuable to the patients and further studies to evaluate the role of Cerebrolysin is warranted.

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