Pharmacological stimulant treatment of neurocognitive and functional deficits after traumatic and non-traumatic brain injury.

The sequelae of a traumatic or acquired brain injury may manifest itself in many ways that include decreased attention and arousal as well as cognitive, emotional and sensorimotor deficits. The discussion that follows will serve as a review of the use of stimulants in the management of patients with strokes or traumatic brain injury. The indications discussed include treating deficits in attention and arousal, as well as facilitating functional recovery. The literature cited has been derived from various research and clinical settings. After briefly reviewing, biochemistry and neuroanatomy, the paper discusses pertinent treatment issues such as the timing of initiation and discontinuation of stimulating medication with emphasis on the varied, current clinical practices. With the complexity of the various neurochemical processes that occur as a result of secondary brain damage, it would be impossible to review all potential stimulating agents in a single article. The authors' intent was to review the most commonly used neurostimulants, various intervention strategies, potential benefits and caveats and long-term outcomes with the use of these medications.