Concentrating on ‘Golden Hours’ of Care to Improve TBI Outcomes


Posted on November 7, 2022

Investigators are accumulating support for technical developments and clinical and translational research for use in the critical hours just after TBIs occur. An approximate 1.5 million Americans sustain a traumatic brain injury every year, according to the Centers for Disease Control and Prevention (CDC).

Generally, TBI is a form of brain injury and dysfunction that cause blows or jolts to the head. TBI can result in cognitive problems, such as an inability to control mood and memory loss, but new investigations are looking to improve these consequences.

Investigation around the “golden hours,” or the treatment directed during the initial hours after injury and the subsequent 24 to 48 hours of care.

“The golden hours are critical,” states Robert Neumar, chair of emergency medicine, M.D., Ph.D., and professor. “They can decide whether a patient survives from their injury and, if so, what type of long-term function and debility issues they may face.”

That’s the reason Neumar and the U-M Center for Integrative Research in Critical Care (MCIRCC) decided to host the Massey Regional TBI Conference to explore the early diagnosis and monitoring treatment of TBI or any other kind of brain injury, with a stress on the golden hours of care.

Academics are working to gather the best and brightest in the industry to improve the outcomes for those affected by severe TBIs. Researchers will present groundbreaking, recently funded technology development projects and research, both translational and clinical, impacting the golden hours and following treatment of TBI.

The projects to be presented are:

Imatinib for aiming PDGF signaling in TBI: 

Researchers will develop an intravenous preparation for Imatinib, a drug used to treat certain types of leukemia, to prove its effectiveness in steadying and averting further damage from secondary concerns of TBI in severe TBI patients.

Ensuring the success of valproic acid as an early treatment for TBI: 

The research group will develop blood markers that will allow them to regulate which TBI patients respond to valproic acid and how valproic acid protects the brain after injury. Valproic acid is a drug used to treat seizures and bipolar disorder.

Invent a digital external ventricular drain system device: 

Scientists plan to develop a digital external ventricular drain system with an integrated cerebral spinal fluid flow monitor/pressure regulator and intracranial pressure monitor. The device will inevitably alert the caregiver to changes in drainage while it adjusts to the patient’s current needs.

Development of software technology to detect and measure hematoma imaging characteristics after TBI automatically: 

The research team will develop a software that will automatically detect and accurately measure hematoma volume, brain compression, and optic nerve diameter in TBI patients’ brain CT scans. This will help identify patients who need critical surgical treatment.

Quantitative pupillometry for sensitive detection and prognosis of TBI:

Researchers will offer clinical evidence supporting the use of quantitative pupillary light reflex measurements as a reliable TBI biomarker. This could lead to the invention of a device for first responders to determine whether a patient has suffered a TBI and its severity.

Massey Foundation TBI Grand Challenge followed after they had their own experience with TBI. A car accident injured wife and mother, Joyce Massey. TBI’s effects completely impaired her daily function, including difficulty with breathing, speaking, and eating. The Massey family offered their gift to U-M in hopes of sparing other families with their experience. It includes funding for clinical research, translational research, technology innovation, a patient-family support fund, and the annual TBI Grand Challenge.