Do We Need to Repeat the Initially Normal Head Computerized Tomography for Patients with Mild Head Trauma Using Anticoagulant and/or Antiplatelet Therapy?

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Catal Y., Günalp Eneyli M., Genç S., Oğuz A. B., Koca A., Polat O.

KONURALP TIP DERGISI, vol.15, no.1, pp.122-129, 2023 (ESCI) identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.18521/ktd.1167329
  • Journal Name: KONURALP TIP DERGISI
  • Journal Indexes: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Page Numbers: pp.122-129
  • Keywords: initially Anticoagulant Drugs, Antiplatelet Drugs, Head Trauma, Intracranial Hemorrhage, DELAYED INTRACRANIAL HEMORRHAGE, BRAIN-INJURY, ORAL ANTICOAGULANTS, WARFARIN, CT, COMPLICATIONS, MANAGEMENT, VISITS, ADULTS
  • Open Archive Collection: AVESIS Open Access Collection
  • Ankara University Affiliated: Yes

Abstract

Objective: Patients using anticoagulant and/or antiplatelet (AC/AP) medications are at an increased risk of intracranial hemorrhage (ICH) subsequent to head trauma and current guidelines recommend a head computed tomography (CT) scan for these patients. There is a lack of consensus about management recommendations for mild head trauma patients on AC/AP treatment who had an initially normal head CT. The aim of this study was to determine the rate of delayed ICH after a 24-hour observation in patients with mild head trauma using AC/AP who had an initially normal head CT. Method: Patients aged 18 and older, using AC/AP drugs with mild head trauma were included prospectively. Patients underwent head CT for suspected bleeding. A repeat CT scan was performed after a 24-hours observation period for the patients who had an initially normal head CT for detecting delayed intracranial hemorrhage. Results: A total of 101 patients were included and, 57.4% (n=58) of the patients were female. Delayed ICH was detected in 2.9% (n=3) of the patients after a 24-hour observation. None of the patients with delayed ICH needed surgical treatment or further intervention. Delayed ICH was found in patients who used acetylsalicylic acid (n=1), dabigatran (n=1), and apixaban (n=1). Conclusion: In patients with mild head trauma using AC/AP, delayed intracranial hemorrhage is rare and may be clinically insignificant. A repeat CT scanning after 24-hour observation may not be necessary for patients with mild head trauma using AC/AP therapy who had initially normal head CT.