OBJECTIVE: To evaluate all the possible therapeutic measures concerning the 
acute management of traumatic brain injury (TBI) mentioned in Cochrane 
Systematic Reviews published in the Cochrane Database of Systematic Reviews 
(CDSR).
METHODS: An exhausted literature search for all published Cochrane Systematic 
Reviews discussing therapeutic rather than prevention or rehabilitative 
interventions of TBI was conducted. We retrieved such databases as CDSR and 
Cochrane Injury Group, excluded the duplications, and eventually obtained 20 
results, which stand for critical appraisal for as many as 20 different measures 
for TBI patients. The important data of each systematic review, including total 
population, intervention, outcome, etc, were collected and presented in a 
designed table. Besides, we also tried to find out the possible weakness of 
these clinical trials included in each review.
RESULTS: Analysis of these reviews yielded meanfuling observations: (1) The 
effectiveness of most ordinary treatments in TBI is inconclusive except that 
corticosteroids are likely to be ineffective or harmful, and tranexamic acid, 
nimodipine and progesterone show a promising effect in bleeding trauma, 
traumatic subarachnoid hemorrhage, TBI or severe TBI. (2) A majority of the 
systematic reviews include a small number of clinical trials and the modest 
numbers of patients, largely due to the uncertainty of the effectiveness. (3) 
The quality of most trials reported in the systematic reviews is more or less 
questionable. (4) In addition, lots of other complex factors together may lead 
to the inconclusive results demonstrated in the Cochrane Systematic Reviews.
CONCLUSIONS: For clinical physicians, to translate these conclusions into 
practice with caution is essential. Basic medication and nursing care deserve 
additional attention as well and can be beneficial. For researchers, high 
quality trials with perfect design and comprehensive consideration of various 
factors are urgently required.