Emerging treatments
Omega-3 fatty acids
There is interest in the use of omega-3 fatty acids as a potential treatment for mild traumatic brain injury (TBI). A double-blind, randomized controlled pilot trial of docosahexaenoic acid (DHA) following sport-related concussion in athletes ages 14-18 years found that DHA was well-tolerated and did not significantly affect recovery times.[109] Other clinical trials are recruiting, or are underway, but none has yet posted results.[110][111]
Tranexamic acid
One large randomized controlled trial (12,737 patients) showed a reduction in mortality in patients with mild-to-moderate head injury (baseline GCS 9-15) who were treated with tranexamic acid (an antifibrinolytic agent) within three hours of injury, compared with those who were not.[112] However, its results should be interpreted with some caution due to: significance only in the subgroup analysis; change in recruitment (from within 8 to within 3 hours of injury); change in primary outcome (from all-cause to disease-specific mortality); and the risk of selection and observer bias. One randomized controlled trial published in 2020 (n=1280, 20 centers and 39 emergency medical services agencies in the US and Canada) compared tranexamic acid with placebo within two hours of moderate or severe TBI.[113] A favorable functional neurologic outcome (measured as Glasgow Outcome Scale-Extended >4 at 6 months) occurred in 65% of patients in the tranexamic acid groups versus 62% with placebo. There was no statistically significant difference in all-cause 28-day mortality, Disability Rating Scale score at 6 months, or progression of intracranial hemorrhage.
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