Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management

摘要: Summary Normal haemostasis depends on an intricate balance between mechanisms of bleeding and thrombosis, this can be altered after traumatic brain injury (TBI). Impaired could exacerbate the primary insult with risk initiation or aggravation bleeding; anticoagulant use at time also contribute to TBI. Many patients TBI have abnormalities conventional coagulation tests admission emergency department, presence coagulopathy is associated increased morbidity mortality. Further blood testing often reveals a range changes affecting platelet numbers function, procoagulant factors, fibrinolysis, interactions system vascular endothelium, tissue, inflammatory mechanisms, flow dynamics. However, degree which these affect outcomes whether they are modifiable factors not known. Although main challenge for management address hypocoagulopathy prolonged progression haemorrhagic lesions, hypercoagulopathy prothrombotic tendency warrants consideration.