Inclusion Criteria:

- Adults (18 - 60 years old)

- Severe traumatic brain injury with intracranial pressure monitoring

- Initial GCS 5-8 (obtained free of the effects of neuromuscular blockade or sedatives)

- Clearly defined time of injury no more than 8 hours before administration of study
drug

- Written consent obtained from legally authorized representative (LAR)

- Severe swelling prone injury patterns:

1. Contusion - frontal or temporal (> 20 cc)

2. Acute convexity subdural hematoma with any evidence of midline shift

Exclusion Criteria:

- Patients undergoing emergent (within 15 minutes) or urgent neurosurgery (within 4
hours) following emergency department arrival (bedside procedures, such as
intracranial pressure monitor placement are excluded)

- Posterior fossa lesions

- Penetrating brain injury

- Spinal column instability and/or spinal cord injury with neurological deficit

- Pregnant

- Concomitant severe nonsurvivable injury

- Acute renal failure ; Chronic renal failure (serum creatinine of > 2.5 mg/dL, history
of ongoing dialysis, glomerular filtration rate <30mL/min/1.73 m2); Severe pulmonary
edema; Severe heart failure; Severe liver failure (AST, ALT, or bilirubin > 2 times
normal)

- Known use of warfarin, clopidogrel, prasugrel, cilostazol, heparin, low molecular
weight heparin, heparinoids, abciximab or similar antiplatelet agents

- Treatment with another investigational drug within the prior 30 days

- Systolic blood pressure < 90 mm HG not responsive to fluid resuscitation

- INR > 1.4

- Hospitalization for brain injury or neurological disease within previous 3 years

- Admission serum sodium < 135 mmol/L

- > 8 hours from the time of injury to admission

- Fix/dilated pupil suspected to be secondary to brainstem compression

- Duret (brainstem) hemorrhage indicating brainstem herniation

- PaO2 < 60 mmHg on admission (when blood gases are drawn as standard of care)

- Prisoner or other persons unable to make a true, voluntary and uncoerced decision
whether or not to participate in the study