title: Effects of Oral Glibenclamide on Brain Contusion Volume and Functional Outcome of Patients with Moderate and Severe Traumatic Brain Injuries: A Randomized Double-Blind Placebo-Controlled Clinical Trial.
abstract: OBJECTIVE
  This study investigated effects of oral glibenclamide on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injuries.
  
  
  METHODS
  A randomized clinical trial including 66 patients with moderate (Glasgow Coma Scale score 9-12) to severe (Glasgow Coma Scale score 5-8) traumatic brain injury and brain contusions of <30 mL volume was conducted from May 2015 to August 2016 in a Level I trauma center in southern Iran. Patients who required surgical intervention were excluded. Patients were randomly assigned to receive 10 mg oral glibenclamide daily for 10 days (n = 29) or placebo in the same dosage (n = 23). Brain contusion volumetry was performed on days 0, 3, and 7 using spiral thin-cut brain computed tomography scan (1-mm thickness). Outcome measures including modified Rankin Scale, Glasgow Outcome Scale, and Disability Rating Scale were evaluated 3 months after injury.
  
  
  RESULTS
  There was no significant difference between the 2 study groups in baseline, day 3, and day 7 contusion volumes. Patients receiving glibenclamide had a significantly lower expansion ratio from first to second volumetry (P < 0.001). Similarly, the first to third expansion ratio was significantly lower in the glibenclamide group compared with placebo (P = 0.003). There was no significant difference between the 2 groups regarding functional outcome measured by Glasgow Outcome Scale, modified Rankin Scale, and Disability Rating Scale.
  
  
  CONCLUSIONS
  Oral glibenclamide is associated with decreased contusion expansion rate in patients with moderate and severe traumatic brain injuries sustaining cerebral contusions.
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hosseinali
authors.initials: H
authors.lastname: Khalili
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: nima_med83@yahoo.com.
authors.forename: Nima
authors.initials: N
authors.lastname: Derakhshan
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Niakan
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.affiliation: Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Salehi
authors.affiliation: Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Eshraghian
authors.affiliation: Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Shakibafard
authors.affiliation: Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran; Radiology Department, Chamran Hospital, Shiraz, Iran.
authors.forename: Bita
authors.initials: B
authors.lastname: Zahabi
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D015600:Glasgow Coma Scale; D005905:Glyburide / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007492:Iran; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D005905:Glyburide
keywords: Contusion; Functional outcome; Glibenclamide; Traumatic brain injury