BRAIN INJURY AND IBUPROFEN

BRAIN INJURY AND IBUPROFEN

As a trial lawyer who devotes substantial times and resources studying both the law and the science involved in traumatic brain injury, I continue to be fascinated by the amount of learning that I do. In part, this educational process is aided by my role as Editor-in-Chief of the Traumatic Brain Injury Litigation Group Newsletter. The TBILG is a group sponsored by the American Association for Justice .

Recently, I have been engaged in a dialogue that recognizes that a traumatic brain injury is not an event but an evolving process. The injured brain responds like other parts of the body that become injured. The body reacts to a brain injury by producing a variety of chemical substances as a defensive and/or healing mechanism. These chemical reactions, in some cases, actually cause further and continuing damage to the brain that might only be detected by very sophisticated neuropsychological testing that demonstrates cognitive deterioration.

Part of the scientific study that is ongoing in this area of medicine involves the use of pharmaceutical agents to try to overcome the adverse effects of brain injury. Understandably, studies that involve humans are limited because with brain injuries, no one wants to become a human guinea pig. However, conclusions can be drawn from animal studies.

Recently I came across a very interesting study published in the journal Experimental Neurology. The article is entitled: “Chronic ibuprofen administration worsens cognitive outcome following traumatic brain injury in rats” by Kevin D. Browne et al. Experimental Neurology 201 (2006) 301-307. Ibuprofen is a widely used non-steroidal anti-inflammatory drug (NSAID) used to control pain and reduce inflammation either from a chronic condition or an acute traumatically induced condition. According to the article, the use of Ibuprofen has had positive results in treating Alzheimer’s disease and preventing cognitive decline. Thus, it seemed logical that the same result might be found by using Ibuprofen on traumatic brain injury victims. The result, however, was not encouraging as chronic use of Ibuprofen was found to worsen cognitive function in rats studied with induced TBI.

Because most traumatic brain injuries in humans also involve an assortment of other injuries many of which involve inflammatory processes involving the musculoskeletal system (broken bones, torn cartilage and tendons, muscle and ligament injuries, etc), it is quite common for physicians to recommend that a patient use a NSAID or the patient self-medicates with a NSAID. Such NSAIDs include: Advil, Advil Liqui-Gels, Advil Migraine, Genpril, Haltran, Junior Strength Advil, Junior Strength Motrin, Menadol, Midol Maximum Strength Cramp Formula, Motrin, Motrin IB, Motrin Migrain Pain, Nuprin and Rufen. If the conclusions of this Ibuprofen study can be extended to humans who suffer traumatic brain injury, then the use of such NSAIDs chronically may be good for the joints but harmful to cognition.