Crazy as it sounds, alcohol may one day be given to people with brain injuries to help them recover.

The idea has arisen from a study of 38,000 people with head injuries, which found that those with alcohol in their blood were more likely to survive. For every 100 people who died when stone-cold sober, only 88 died with ethanol – the kind of alcohol in drinks – in their veins.

“The finding raises the intriguing possibility that administering ethanol to patients with brain injuries may improve outcome,” conclude the investigators.

Lead researcher Ali Salim of the Cedars-Sinai Medical Center in Los Angeles said he hoped a trial could be mounted, but more information is needed first. “We need a better understanding of the exact mechanism, the appropriate dose and specific timing of treatment before we can embark on clinical trials,” he told New Scientist.


Brain teaser

Salim said that several previous studies have found similar beneficial effects – although others do not. Animal experiments, meanwhile, suggest that relatively low doses of alcohol protect the brain from injury, but high doses increase the risk of death.

More research is also needed to establish how alcohol protects the brain, but Salim says it may work by blunting the amount of adrenalin reaching the brain, which reduces inflammation.

Despite alcohol’s potential for helping patients survive brain injury, Salim stressed that it is to blame for half of all injury cases.

“Alcohol is and will always continue to be bad, since it contributes to over 40 per cent of traffic-related fatalities,” he says.

The study also found that drinkers suffered more complications and more severe injuries than non-drinkers, even though the overall survival rate was higher.

Therapeutic time window

David Hovda, director of the Brain Injury Research Center at the University of California at Los Angeles, agreed that more research is needed before a clinical trial could take place.

“One would have to know the therapeutic time window and, of course, the dose,” he says. “But the mechanisms of action involving the neurobiology of traumatic brain injury have different timeframes and regional profiles which would make ethanol therapy difficult to manage correctly.”

Hovda also points out that brain injuries can be very diverse, so ethanol might work for some but not others. “Severity and type really make a difference when deciding on therapeutic options,” he says.

Journal reference: Archives of Surgery, vol 144, p 865