Therapeutic use of omega-3 fatty acids in severe head trauma

The American Journal of Emergency Medicine August 3, 2012 [epub] Michael Lewis, MD; Parviz Ghassemi; Joseph Hibbeln, MD BACKGROUND: On January 2, 2006, in Upshur County, West Virginia, USA, there was an explosionin the Sago Coal Mine. The blast trapped 13 miners for nearly two days; only oneminer survived. The lone survivor was Randal L. McCloy, Jr., age 26. He was found practically dead, unconscious and suffering from carbon monoxide poisoning, acollapsed lung, brain hemorrhaging, edema, muscle injury, faulty liver and heartfunction, and almost no brain electrical activity. His initial prognosis for recoverywas grim, expecting permanent damage to his brain. However, McCloy recovered almost fully. McCloy is the longest exposure to carbon monoxide poisoning to have survived. Hisdoctors predicted that if he did survive, he would be severely brain damaged sincethe carbon monoxide had stripped the protective myelin sheath from most of hisbrain’s neurons. McCloys neurosurgeon started to enternally feed him a daily dose of 15,000milligrams (mg) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) fishoil. Soon, his brain electrical activity returned and he emerged from his coma, graduallyregaining his ability to walk, talk, and see. Apparently the omega-3s helped rebuildthe damaged gray and white matter of his brain. McCloy is now married, haschildren, and is largely functioning normally. The authors of this study state: We are aware of only one report where n-3FA were used, that being thesurvivor of the Sago Mine accident in January 2006 suffering from hypoxiaand exposure to toxic gases, dehydration, and rhabdomyolysis.[Roberts L, Bailes J, Dedhia H, et al.; Surviving a mine explosion; J Am Coll Surg,207 (2) (2008), pp. 276 – 283] {Dr. Bailes was McCloys neurosurgeon} These authors then present a case study stating:To our knowledge, this is the first report of specific use of substantial amounts ofn-3FA following severe TBI. * A teenager sustained a severe TBI in a motor vehicle accident. 2 * His extrication prolonged, he was in a coma, he sustained a subduralhematoma that was surgically decompressed. * The attending neurosurgeons believed the injuries were likely fatal. * On day 10, (still in a coma), MRI showed significant subdural hemorrhageand diffuse axonal injury. His doctors believed him to be in a permanentvegetative state. * A tracheotomy and percutaneous endoscopic gastrostomy (PEG) tube wereplaced for custodial care and enteral feedings were started. * On Day 11, 9,756 mg eicosapentaenoic acid (EPA) and 6,756 mg docosahexaenoic acid (DHA) per day were added to enteral feedings. * On day 21, he was weaned off the ventilator and transported to a specializedrehabilitation institute 3 days later. * 3 months after the injury the patient attended his high school graduation toreceive his diploma. * 4 months after the injury the patient was discharged to home. * For the following year, the patient continued to take 16,500 mg of EPA + DHAfish oil supplements per day along with 6000 IU of vitamin D3; hisimprovement continued and he experienced no adverse effects.