Delayed intracranial hemorrhage after head trauma seems rare and rarely needs intervention—even in antiplatelet or anticoagulation therapy

International Journal of Emergency Medicine

Research

Henrik Bergenfeldt¹  Tomas Vedin¹  Ebba Anefjäll²  Jakob Lundager Forberg²  Riikka Lehtinen² 

[1] Clinical Research Centre, Department of Clinical Sciences, Skåne University Hospital, Lund University, Box 50332, 20213, Malmö, Sweden;Clinical Sciences, Helsingborg General Hospital, Lund University, Svartbrödragränden 3-5, 25187, Helsingborg, Sweden;

关键词: MESH;    Brain injuries;    Traumatic intracranial hemorrhages;    Traumatic anticoagulant tomography;    X-ray computed;   

DOI  :  10.1186/s12245-023-00530-z

 received in 2023-03-30, accepted in 2023-08-20,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTraumatic brain injury causes morbidity, mortality, and at least 2,500,000 yearly emergency department visits in the USA. Computerized tomography of the head is the gold standard to detect traumatic intracranial hemorrhage. Some are not diagnosed at the first scan, and they are denoted “delayed intracranial hemorrhages. ” To detect these delayed hemorrhages, current guidelines for head trauma recommend observation and/or rescanning for patients on anticoagulation therapy but not for patients on antiplatelet therapy. The aim of this study was to investigate the prevalence and need for interventions of delayed intracranial hemorrhage after head trauma.MethodsThe study was a retrospective review of medical records of adult patients with isolated head trauma presenting at Helsingborg General Hospital between January 1, 2020, and December 31, 2020. Univariate statistical analyses were performed.ResultsIn total, 1627 patients were included and four (0.25%, 95% confidence interval 0.06–0.60%) patients had delayed intracranial hemorrhage. One of these patients was diagnosed within 24 h and three within 2–30 days. The patient was diagnosed within 24 h, and one of the patients diagnosed within 2–30 days was on antiplatelet therapy. None of these four patients was prescribed anticoagulation therapy, and no intensive care, no neurosurgical operations, or deaths were recorded.ConclusionTraumatic delayed intracranial hemorrhage is rare and consequences mild and antiplatelet and anticoagulation therapy might confer similar risk. Because serious complications appear rare, observing, and/or rescanning all patients with either of these medications can be debated. Risk stratification of these patients might have the potential to identify the patients at risk while safely reducing observation times and rescanning.

【 授权许可】

CC BY   
© Springer-Verlag GmbH Germany, part of Springer Nature 2023

【 图 表 】

13690_2023_1170_Article_IEq58.gif