Journal of neurosurgery
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Journal of neurosurgery · Oct 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter trial on the efficacy of using tirilazad mesylate in cases of head injury.
The authors prospectively studied the efficacy of tirilazad mesylate, a novel aminosteroid, in humans with head injuries. ⋯ Striking problems with imbalance concerning basic prognostic variables were observed in spite of the large population studied. These imbalances concerned pretreatment hypotension, pretreatment hypoxia, and the incidence of epidural hematomas. In future trials of pharmacological therapy for severe head injury, serious consideration must be given to alternative randomization strategies. Given the heterogeneous nature of head injury and the identification of populations that do relatively well with standard therapy, target populations with a higher risk for mortality and morbidity may be more suitable for clinical trials of such agents.