Traumatic Intracranial Hemorrhage Correlates with Preinjury Brain Atrophy, but Not with Antithrombotic Agent Use: A Retrospective Study

摘要: BACKGROUND The impact of antithrombotic agents (warfarin, clopidogrel, ASA) on traumatic brain injury outcomes is highly controversial. Although cerebral atrophy speculated as a risk for acute intracranial hemorrhage, there no objective literature evidence. MATERIALS AND METHODS This retrospective, consecutive investigation patients with signs external head trauma and age ≥60 years. Outcomes were correlated antithrombotic-agent status, coagulation test results, admission neurologic function, CT-based dimensions. RESULTS Of 198 patients, 36% antithrombotic-negative 64% antithrombotic-positive. ASA had higher arachidonic acid inhibition (p = 0.04) warfarin INR (p<0.001), compared to patients. Antithrombotic-positive hemorrhage rate (38.9%) was similar the (31.9%; p = 0.3285). Coagulopathy not present ten standard coagulation, thromboelastography, platelet mapping tests results those without (p≥0.1354). Hemorrhagic-neurologic complication (intracranial progression, need craniotomy, deterioration, or death) rates (6.9%) antithrombotic-positive (8.7%; p = 0.6574) hemorrhagic-neurologic increased when major dysfunction (63.2% versus 2.2%; RR = 28.3; p<0.001). Age inversely parenchymal width (p<0.001) positively lateral ventricular (p = 0.047) cortical (p<0.001). Intracranial CONCLUSIONS associated agent use. have demonstrable coagulopathy. association preinjury novel finding. Contrary abnormality predictor adverse post-admission outcomes. Study findings indicate that effective hemostasis maintained therapy.