• Proportion of Participants With Improvement in Glasgow Outcome Scale - Extended (GOS-E) [ Time Frame: Day 90 ]
  The Glasgow Outcome Scale (GOS) is a global scale for functional outcome that rates participant status into one of five categories: Dead, Vegetative State, Severe Disability, Moderate Disability or Good Recovery. The Extended GOS (GOS-E) provides more detailed categorization into eight categories by subdividing the categories of severe disability, moderate disability and good recovery into a lower and upper category.
• Proportion of Participants With Improvement in Modified Rankin Scale (mRS) [ Time Frame: Day 90 ]
  The mRS measures the degree of disability or dependence in the daily activities of participants who have suffered a stroke or other causes of neurological disability. The scale runs from 0-6, ranging from perfect health without symptoms (0) to dead (6).
• Proportion of Participants Requiring Delayed Intubation [ Time Frame: Day 1 (Hour 24) to Day 4 (Hour 96) ]
  Delayed intubation is defined as participants requiring intubation (for neurologic deterioration only) at any time between 24 hours and 96 hours postinjury.
• Change from Baseline in Absolute Hematoma Volume at Hour 24 [ Time Frame: Baseline up to Day 1 (Hour 24) ]
• Change from Baseline in Absolute Edema Volume at Hour 96 [ Time Frame: Baseline up to Day 4 (Hour 96) ]
• Time to All-cause Death [ Time Frame: Baseline up to Day 90 ]
  The treatment effects on overall survival of participants, including neurological death, will be assessed.

The primary objective is to determine if BIIB093 reduces brain contusion expansion by Hour 96 when compared to placebo.

The secondary objectives are to evaluate the effects of BIIB093 on acute neurologic status, functional outcomes, and treatment requirements, to further differentiate the mechanism of action of BIIB093 on contusion expansion by examining differential effects on hematoma and edema expansion, and to determine if BIIB093 improves survival at Day 90 when compared to placebo.

• Drug: BIIB093
  Administered as specified in the treatment arm.
  Other Names:

  • Glibenclamide
  • CIRARA
  • RP 1127
• Drug: Placebo
  Administered as specified in the treatment arm.

• Experimental: BIIB093 3 mg
  Participants will be administered BIIB093 3 mg/day as a bolus followed by rapid and slow intravenous (IV) infusions for 96 hours.
  Intervention: Drug: BIIB093
• Experimental: BIIB093 5 mg
  Participants will be administered BIIB093 5 mg/day as a bolus followed by rapid and slow IV infusions for 96 hours.
  Intervention: Drug: BIIB093
• Placebo Comparator: Placebo 3 mg
  Participants will be administered matching placebo to BIIB093 as a bolus followed by rapid and slow IV infusions for 96 hours.
  Intervention: Drug: Placebo
• Placebo Comparator: Placebo 5 mg
  Participants will be administered matching placebo to BIIB093 as a bolus followed by rapid and slow IV infusions for 96 hours.
  Intervention: Drug: Placebo

Key Inclusion Criteria:

• Clinical diagnosis of brain contusion with lesions within the supratentorial brain parenchyma totaling > 3 mL in volume per Investigator assessment of baseline non-contrast computed tomography scan (NCCT) at Screening.
• A score of 5 to 15 on the Glasgow Coma Scale (GCS)
• Functionally independent, in the opinion of the Investigator, prior to index head injury.

Key Exclusion Criteria:

• In the judgment of the Investigator, participant is likely to have supportive care withdrawn within 24 hours.
• Clinical signs of brainstem herniation, in the opinion of the Investigator.
• NCCT or magnetic resonance imaging (MRI) evidence of penetrating brain parenchyma. Cerebrospinal fluid leak in isolation is not exclusionary unless evidence of parenchymal penetration by an external force (e.g., blunt object, bullet, or depressed skull fracture).
• Any presence of midbrain or posterior fossa injury as assessed by imaging and clinical examination.
• Presence of concomitant spinal cord injury as assessed by imaging and clinical examination.
• Polytrauma (intra-abdominal or orthopedic trauma) requiring operative/surgical management, if known. Minor fractures requiring splinting or reduction of dislocations are permitted, as are nonoperative intra-abdominal injuries or placement of noninvasive external fixation devices.
• Use of novel oral anticoagulants (NOACS; including direct thrombin inhibitors such as dabigatran, or Factor Xa inhibitors such as rivaroxaban or apixaban), in preceding 3 days prior to the injury, if known.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.