Limited benefit of systematic head CT for mild traumatic brain injury in patients under antithrombotic therapy
| Autor: | Sahara Graf, Nicolas Thellier, Lucie Colas, Gregory Bertolotti, Jean-François Budzik, Juliette Ding, Sébastien Verclytte |
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| Rok vydání: | 2023 |
| Předmět: |
education.field_of_study
Radiological and Ultrasound Technology Traumatic brain injury business.industry medicine.drug_class Significant difference Population Anticoagulant medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences Antithrombotic treatment 0302 clinical medicine Anesthesia Antithrombotic medicine Platelet aggregation inhibitor Radiology Nuclear Medicine and imaging In patient Neurology (clinical) education business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neuroradiology. 50:30-35 |
| ISSN: | 0150-9861 |
| Popis: | Background and purpose Mild traumatic brain injury (mTBI) in patients on antiplatelet (AP), anticoagulant (AC) or direct oral anticoagulant (DOAC) medication has become a systematic indication for head CT. However, the over-risk and impact of the intracranial hemorrhages (IH) detected with CT in this population remain unclear and need to be assessed. Materials and methods We prospectively assessed head CTs performed in adults taking AP/AC/DOAC referred after a mTBI to our Emergency Departments between September 2016 and January 2018. Frequency, type and severity of IH were described and frequency was analyzed as a function of treatment. Results 840 patients were prospectively included. 58.9% were treated with AP, 23.7% with AC, 11.7% with DOAC and 5.7% with a combination of antithrombotic agents. The rate of IH detected with head CT was 5.8% (n = 49), of which 81.6% (n = 40) and 18.4% (n = 9) with minor and intermediate severity respectively. No patient required surgical care and no death occurred. No statistically significant difference was found in treatment distribution between patients with or without IH (p = 0.98). Among the patients who discontinued their antithrombotic treatment after mTBI, three experienced thrombotic events during the hospitalization. Conclusions Our results showed a low frequency and severity of IH in mTBI patients indifferently treated with AP, AC or DOAC, without secondary neurological deterioration, death or need of surgical care. Our study suggests the limited benefit of systematic CT head scan as a standard practice for the management of mTBI patients under antithrombotic therapy. |
| Databáze: | OpenAIRE |
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