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Head trauma: basic, preclinical, and clinical directions
  1. Peter J Kirkpatrick

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Miller and Hayes have assembled chapters from 42 expert contributors renowned for their work in investigation of traumatic brain injury. They have divided the text into three main sections, basic science: overview; preclinical studies, and clinical directions.

Organising the text in this way the authors have struck a theme which passes from experimental concepts through to preclinical feasibility studies and eventually on to clinical trials. They acknowledge from the outset that the wealth of basic scientific information gathered over the past 3 decades has not led to substantial clinical gain. The reasons for this are debated in a latter chapter.

The work represents a comprehensive review of the information available on traumatic brain injury. The basic science overview I found to be particularly well written and concise, introducing concepts and experimental data in a highly readable way. The main theories of cytotoxicity, inflammatory response, apoptosis, traumatic axonal injury, and mitochondrial dysfunction have separate attention, as do the important vascular aspects of severe head injury.

The final section refers to the clinical efforts of attempting to translate scientific knowledge into clinical work. The major clinical trials organised in the United States, Europe, and Asia are discussed and potential reasons for their failure debated.

In summary the work of Miller and Hayes is a valuable addition to the reading of those involved in traumatic brain injury. This is particularly so for those who engage in the experimental and clinical design of novel therapies for the traumatised brain.

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