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Case Reports
. 2013 Jan;31(1):273.e5-8.
doi: 10.1016/j.ajem.2012.05.014. Epub 2012 Aug 3.

Therapeutic Use of omega-3 Fatty Acids in Severe Head Trauma

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Free PMC article
Case Reports

Therapeutic Use of omega-3 Fatty Acids in Severe Head Trauma

Michael Lewis et al. Am J Emerg Med. .
Free PMC article

Abstract

Traumatic brain injury (TBI) has long been recognized as the leading cause of traumatic death and disability. Tremendous advances in surgical and intensive care unit management of the primary injury, including maintaining adequate oxygenation, controlling intracranial pressure, and ensuring proper cerebral perfusion pressure, have resulted in reduced mortality. However, the secondary injury phase of TBI is a prolonged pathogenic process characterized by neuroinflammation, excitatory amino acids, free radicals, and ion imbalance. There are no approved therapies to directly address these underlying processes. Here, we present a case that was intentionally treated with substantial amounts of omega-3 fatty acids (n-3FA) to provide the nutritional foundation for the brain to begin the healing process following severe TBI. Recent animal research supports the use of n-3FA, and clinical experience suggests that benefits may be possible from substantially and aggressively adding n-3FA to optimize the nutritional foundation of severe TBI patients and must be in place if the brain is to be given the opportunity to repair itself to the best possible extent. Administration early in the course of treatment, in the emergency department or sooner, has the potential to improve outcomes from this potentially devastating public health problem.

Figures

Figure One
Figure One
Computerized tomography scan of the patient approximately two hours after the motor vehicle accident and prior to neurosurgery. Note the moderate sized panhemispheric right subdural hematoma, a small right temporal epidural hematoma, subarachnoid hemorrhage, and three millimeter right to left shift of the midline.
Figure Two
Figure Two
T2-weighted magnetic resonance imaging on hospital day ten. Note the right cerebral convexity subdural hemorrhage, right postcentral gyrus and left temporal lobe parenchymal petechial hemorrhage, and small superior vermian subarachnoid hemorrhage in the image on the right. Additionally, multiple zones of abnormal FLAIR signal consistent with diffuse axonal injury are present on both images.

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