{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:10:36Z","timestamp":1778281836347,"version":"3.51.4"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Moderate traumatic brain injury (TBI) with nonoperative intracerebral hemorrhage (ICH) presents a significant challenge in neurorehabilitation, often lacking targeted pharmacological interventions. Cerebrolysin, a neuropeptide compound with proposed neurotrophic and neuroprotective properties, may support recovery in this population. This study aimed to evaluate the clinical efficacy and safety of Cerebrolysin in adults with moderate TBI and nonoperative ICH over a 6-month period.<\/jats:p>\n                  <jats:p>In this prospective, single-blind, controlled cohort study, 340 patients aged 18 to 80 years with moderate TBI and nonoperative ICH were enrolled from two tertiary care centers in Thailand between 2022 and 2024. Participants received either standard care plus Cerebrolysin (30\u2009mL\/day intravenously for 10 days; n\u2009=\u2009160) or standard care alone (n\u2009=\u2009180). The primary outcome was functional improvement assessed by the Coma Recovery Scale-Revised (CRS-R). Secondary outcomes included the Barthel Index (BI), modified Rankin Scale (mRS), and 6-month survival. Safety was evaluated by monitoring seizures, cardiovascular events, and recurrent hemorrhage.<\/jats:p>\n                  <jats:p>The Cerebrolysin group demonstrated significantly greater improvement in CRS-R scores at discharge (20.3\u2009\u00b1\u20092.7 vs. 16.4\u2009\u00b1\u20092.1; p\u2009=\u20090.013), higher BI, lower mRS scores, and improved 6-month survival (59.4 vs. 27.8%; p\u2009&lt;\u20090.001). No significant differences in adverse events were observed between groups.<\/jats:p>\n                  <jats:p>Cerebrolysin may enhance functional recovery and survival in moderate TBI with nonoperative ICH without increasing adverse effects. While Cerebrolysin showed promising effects, the nonrandomized and single-blind design limits causal inference. Further randomized controlled trials are warranted.<\/jats:p>","DOI":"10.1055\/s-0045-1813223","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:14:27Z","timestamp":1763597667000},"page":"241-250","source":"Crossref","is-referenced-by-count":0,"title":["Neuroprotective Effects of Cerebrolysin in Moderate Traumatic Brain Injury with Nonoperative Lesions: A 6-Month Prospective Cohort Analysis"],"prefix":"10.1055","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-1301","authenticated-orcid":false,"given":"Panu","family":"Boontoterm","sequence":"additional","affiliation":[{"name":"Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siraruj","family":"Sakoolnamarka","sequence":"additional","affiliation":[{"name":"Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karanarak","family":"Urasyanandana","sequence":"additional","affiliation":[{"name":"Neurological Surgery Unit, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"ref1","first-page":"1","article-title":"Alzheimer's disease neuropathology is exacerbated following traumatic brain injury. Neuroprotection by co-administration of nanowired mesenchymal stem cells and cerebrolysin with monoclonal antibodies to amyloid beta peptide","volume":"265","author":"H S Sharma","year":"2021","journal-title":"Prog Brain Res"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/bs.pbr.2021.06.016","article-title":"Cerebrolysin restores balance between excitatory and inhibitory amino acids in brain following concussive head injury. Superior neuroprotective effects of TiO2 nanowired drug delivery","volume":"266","author":"H S Sharma","year":"2021","journal-title":"Prog Brain Res"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40120-019-0128-1","article-title":"Cerebrolysin as a new treatment option for post-stroke spasticity: patient and physician perspectives","volume":"8","author":"N Chemer","year":"2019","journal-title":"Neurol Ther"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.3171\/2019.6.JNS191027","article-title":"Randomized controlled trial of Cerebrolysin's effects on long-term histological outcomes and functional recovery in rats with moderate closed head injury","volume":"133","author":"Y Zhang","year":"2019","journal-title":"J Neurosurg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"107216","DOI":"10.1016\/j.clineuro.2022.107216","article-title":"Effect of Cerebrolysin in severe traumatic brain injury: a multi-center, retrospective cohort study","volume":"216","author":"L LN Lucena","year":"2022","journal-title":"Clin Neurol Neurosurg"},{"issue":"11","key":"ref6","first-page":"98","article-title":"Cerebrolysin in the treatment of brain injuries of moderate severity [in Russian]","volume":"114","author":"A E Talypov","year":"2014","journal-title":"Zh Nevrol Psikhiatr Im S S Korsakova"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.clineuro.2016.11.011","article-title":"Effects of cerebrolysin on functional recovery in patients with severe disability after traumatic brain injury: a historical cohort study","volume":"152","author":"H Khalili","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1089\/neu.2014.3558","article-title":"Cerebrolysin Asian Pacific trial in acute brain injury and neurorecovery: design and methods","volume":"32","author":"W Poon","year":"2015","journal-title":"J Neurotrauma"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.jns.2019.01.017","article-title":"Prospective, double blinded, comparative assessment of the pharmacological activity of Cerebrolysin and distinct peptide preparations for the treatment of embolic stroke","volume":"398","author":"L Zhang","year":"2019","journal-title":"J Neurol Sci"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"803","DOI":"10.3109\/02688697.2013.793287","article-title":"Cerebrolysin enhances cognitive recovery of mild traumatic brain injury patients: double-blind, placebo-controlled, randomized study","volume":"27","author":"C C Chen","year":"2013","journal-title":"Br J Neurosurg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jns.2013.11.028","article-title":"Cerebrolysin reduces amyloid-\u03b2 deposits, apoptosis and autophagy in the thalamus and improves functional recovery after cortical infarction","volume":"337","author":"S Xing","year":"2014","journal-title":"J Neurol Sci"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.17116\/jnevro20181185139","article-title":"Anti-inflammatory effects of neurotrophic therapy (a pilot study) [in Russian]","volume":"118","author":"I K Malashenkova","year":"2018","journal-title":"Zh Nevrol Psikhiatr Im S S Korsakova"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1747-4949.2012.00901.x","article-title":"A prospective, randomized, placebo-controlled, double-blind trial about safety and efficacy of combined treatment with alteplase (rt-PA) and Cerebrolysin in acute ischaemic hemispheric stroke","volume":"8","author":"W Lang","year":"2013","journal-title":"Int J Stroke"},{"key":"ref14","first-page":"43","article-title":"Mechanisms of neurotrophic and neuroprotective effects of cerebrolysin in cerebral ischemia [in 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adults with ischemic stroke: a guideline from the American Heart Association\/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists","volume":"115","author":"H P Adams Jr","year":"2007","journal-title":"Circulation"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1038\/nrneurol.2011.89","article-title":"How to make better use of thrombolytic therapy in acute ischemic stroke","volume":"7","author":"G A Donnan","year":"2011","journal-title":"Nat Rev Neurol"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1747-4949.2012.00770.x","article-title":"Neuroprotection for ischaemic stroke: translation from the bench to the bedside","volume":"7","author":"B A Sutherland","year":"2012","journal-title":"Int J Stroke"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s10072-019-04053-5","article-title":"Safety and efficacy of Cerebrolysin in acute brain injury and neurorecovery: CAPTAIN I-a randomized, placebo-controlled, double-blind, Asian-Pacific trial","volume":"41","author":"W Poon","year":"2020","journal-title":"Neurol Sci"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1161\/STROKEAHA.115.009416","article-title":"Cerebrolysin and recovery after stroke (CARS): a randomized, placebo-controlled, double-blind, multicenter trial","volume":"47","author":"D F Muresanu","year":"2016","journal-title":"Stroke"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s10072-019-04181-y","article-title":"Efficacy and safety of Cerebrolysin in neurorecovery after moderate-severe traumatic brain injury: results from the CAPTAIN II trial","volume":"41","author":"D F Muresanu","year":"2020","journal-title":"Neurol Sci"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1468-1331.2010.03092.x","article-title":"Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer's disease: results of a randomized, double-blind, controlled trial investigating three dosages of Cerebrolysin","volume":"18","author":"X A Alvarez","year":"2011","journal-title":"Eur J Neurol"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3390\/brainsci13030507","article-title":"Cerebrolysin in patients with TBI: systematic review and meta-analysis","volume":"13","author":"K Jarosz","year":"2023","journal-title":"Brain Sci"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/bs.irn.2023.07.001","article-title":"Nanowired delivery of antibodies to tau and neuronal nitric 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Life"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"283","DOI":"10.25122\/jml-2020-0146","article-title":"The effect of cerebrolysin on the predictive value of baseline prognostic risk score in moderate and severe traumatic brain injury","volume":"13","author":"C Birle","year":"2020","journal-title":"J Med Life"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"127","DOI":"10.2147\/NDT.S186865","article-title":"Effects of cerebrolysin on functional outcome of patients with traumatic brain injury: a systematic review and meta-analysis","volume":"15","author":"F Ghaffarpasand","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s12035-015-9235-x","article-title":"PLGA nanoparticles loaded cerebrolysin: studies on their preparation and investigation of the effect of storage and serum stability with reference to traumatic brain 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