Two hundred cases of acute head injuries with Glasgow Coma Scale (GCS) 8 or less were taken up for this study. Cases with haematoma or other treatable lesions were excluded from this group. Alternate cases were given pulsed electromagnetic energy therapy. Thus 100 cases received treatment and 100 cases acted as controls. Cases were seen in the casualty and then on admission. The Glasgow Coma Scales were recorded. Thus the cases with diffuse brain damage, multiple contusions and brain oedema in poor states of consciousness - Scale 8 or less were taken up for study.

All cases were treated in the intensive care unit and the same management protocol was followed except that in alternate cases PEMF therapy was also given. Daily clinical assessment of GCS, maintenance of fluid and electrolyte balances and adequate nutrition was managed. Physiotherapy to augment respiratory movements, care of skin, bladder and bowel management was uniform in both groups of cases. Intraventricular pressure measurements were done in 20 cases. PEMF therapy was given in a setting 65/U Sec. pulses of RE 27.12MHz at 600 pulses per second for 30 minutes, 12 hrly. Electromagnetic head was placed over the patient’s head. Alternate side right and left were treated. This was started from the time of admission into the intensive care unit. All cases had CT Scan of the head.

Figure I shows the graph of cases with OCS on admission and at 10th day as regards the PEMF treated cases. Figure 2 shows the same feature as regards the control group. It is notable that in both groups same number of cases died. But there is a definite qualitative improvement in the survivors who received PEMF therapy.


Figure 1                                                                     Figure 2

Serial CT Scans were done and they were compared with the controls. Figures 3 and 4 show the CT of ‘Ka’ on 2nd post head injury day and at 10th day. In the first picture there is clear evidence of oedema and ventricles appear slit like. By 10th day there is disappearance of oedema and the ventricles are seen well. However, in the control cases it took longer ie., 12 to 15 days to see the ventricles. Similar improvement was noted in a 68-year old man with multiple contusions. By 10 days it is seen that his contusions have been absorbed and there is a hypodense subdural haematoma (Figures 5 and 6). Patient improved well and the subdural needed tapping trough a drill hole once. He was able to support himself at the time of discharge.

ICP measurements using intraventricular catheter was done in the first 20 cases. Of them 10 cases had PEMF therapy. It was noted that in the treated cases, the LCP tended to diminish from 5th day from 300mm of water. By 7th day it came to near normal levels of 200 to 250mm of H20. Among the controls the intracranial pressure was beginning to diminish only by the 7th day. Dehydration therapy to combat cerebral oedema was needed in the control cases and only rarely needed in the treated cases. CSF temperature did not rise with PEMF therapy.

After 10th day the cases were shifted out of intensive care ward. The patients were referred to Department of Physical Medicine and Rehabilitation. The relatives were taught basic movements, shifting positions and minimal physiotherapy. This was regularly supervised by the departmental staff. The relatives felt an involvement in the management of cases. Patient’s nutritional status, and electrolyte status were monitored and adequately replaced.


Figure 3                                                                 Figure 4
Figures 7 and 8 show the status of the group vis-a-vis GCS at 30 days. Again it is evident that the PEMF treated cases did better. The improvement noted was rapid in the survivors. In the group treated there were 4 deaths and in the untreated group there were 8 deaths.


Figure 5                                                                  Figure 6