[Preliminary evaluation of risk and effectiveness of early choline alphoscerate treatment in craniocerebral injury].
Pharmacological treatment of craniocerebral injuries (CCI) to a large extent involves correction of metabolic disturbances resulting from primary and secondary mechanisms of trauma. Choline alphoscerate (CA), a substrate of phosphatydylocholine and a carrier of choline, plays a major role in phospholipidic transformation of the neuronal cell wall.


OBJECTIVE
To goal of the study was to evaluate the risk and efficacy of early CA treatment in patients with CCI.


METHODS
Twenty three CCI patients were treated with CA in the years 2001-2002. In 8 cases an acute subdural haematoma with multiple hemorrhagic foci was diagnosed. Six patients were diagnosed with cerebral contusion with multiple hemorrhagic foci, while 9 patients suffered from concussion of the brain. The patients' condition was assessed at admission using the adult trauma score (ATS)--11 patients scored 8 points on the ATS, 4 patients scored 9, and 8 patients scored 11 points.


METHODS
The inclusion criterion was the patient's clinical status at admission in the range 8-11 ATS points. CA was administered according to the following schedule: 1.0 g/d i.m. for 14 days, then 0.8 g/d orally for the next 28 days. AC (Gliatilin) produced by Italfarmaco was used in the study. The cost of this CA treatment was estimated by the producer at PLN 424.


RESULTS
After three months of the treatment an improvement was noted in 96% of the patients. Fourteen patients were independent and professionally active, another five were independent, but did not work, while three patients required permanent care. One patient died because of pneumonia. No complications due to the CA treatment were observed in the group studied.


CONCLUSIONS
Early treatment with CA is safe and as a component of complex pharmacotherapy has a beneficial effect on the treatment outcome in CCI patients.
Mandat
Tomasz
T
Department of Neurosurgery of WIM, Klinika Neurochirurgii WIM w Warszawie.
Wilk
Arkadiusz
A
Manowiec
Radosław
R
Koziarski
Andrzej
A
Zieliński
Grzegorz
G
Podgórski
Jan Krzysztof
JK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005997:Glycerylphosphorylcholine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D005997:Glycerylphosphorylcholine