Traumatic brain injury (TBI), an unmet need: TBI is an alteration in brain function caused by an extal force with evidence of brain pathology. It could be from a bump, blow, blast or jolt to the head including penetrating the cranium. TBI is a public health conc worldwide due to its econom-ic impact. Most TBIs are survivable, do not need hospitaliza-tion but may influence productivity. A smaller percentage of TBI due to falls or penetrating TBI (PTBI) needs hospitaliza-tion and accounts for largest fraction of TBI care costs. PTBI especially that involving firearm injury is an increasingly serious issue. In the United States, PTBI is an issue both in the military and civilian context costing more than $70-75 billion annually. PTBI has become increasingly survivable including previously lethal midline crossing of projectile due to brain trauma foundation guidelines as well as timely neurosurgical intervention. The extent of recovery is propor-tional to initial damage; injuries limited to single hemisphere stabilize earlier than those crossing the midline do. However, currently the consequence of surviving a PTBI is most likely to be permanent disability. Rate of disability has not changed over the past 5 decades. Almost 3.2 million Americans live with neurobehavioral disability i.e., chronic cognitive and functional impairment requiring support from their families and the State, with lifetime costs of millions of dollars per patient. The TBI lesion is dynamic with continued brain at-rophy, which correlates with persistent neurological deficit and overall social outcome. Observations of post-TBI tissue loss by pathologists were confirmed by longitudinal imaging studies in living TBI survivors. Progressive volume loss was coincident with persistent neuroinflammation thought to be due to chronic microglial activation (Smith, 2013; Lee et al., 2018). In a study of veterans living with TBI spanning