Potential role of vitamin B12 supplementation in neurological recovery after severe traumatic brain injury.

BACKGROUND

Traumatic brain injury (TBI) is a leading cause of mortality and long-term disability worldwide, with limited disease-modifying therapeutic options. Preclinical studies suggest a neurotrophic role for vitamin B12 in neuronal repair and functional recovery. In this setting, the metabolic, neurotrophic and nutritional properties of vitamin B12 may play a crucial role.

CASE-PRESENTATION: We report the case of a 47-year-old male presenting with severe TBI following a road traffic accident, presenting with a severe TBI at admission and leading to diffuse axonal injury. After initial stabilization and intensive care management, the patient showed persistent cognitive and motor deficits, including disorientation, agitation, and left upper limb weakness. Despite standard supportive care, neurological recovery remained limited. Based on emerging evidence, intramuscular vitamin B12 was initiated.

RESULTS

A rapid and marked neurological improvement was already evident by the third day after initiation of intramuscular vitamin B12 supplementation. The patient achieved full cognitive recovery, restoration of motor strength, and resolution of behavioral disturbances, with minimal residual symptoms at discharge.

CONCLUSIONS

This case highlights a possible adjunctive role of vitamin B12 in promoting neurological recovery after severe TBI. While causality cannot be established, the temporal association and biological plausibility support further investigation on vitamin B12 properties through controlled clinical studies.