Research Reports - The effect of tranexamic acid in traumatic brain injury

Chin J Traumatol. 2017 Feb;20(1):49-51. doi: 10.1016/j.cjtee.2016.02.005. Epub
2017 Jan 20.

Jokar A(1), Ahmadi K(2), Salehi T(1), Sharif-Alhoseini M(3), Rahimi-Movaghar
V(4).

PURPOSE: Traumatic brain injury (TBI) is a leading cause of death and disability.
Intracranial hemorrhage (ICH) secondary to TBI is associated with a high risk of
coagulopathy which leads to increasing risk of hemorrhage growth and higher
mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid (TA)
might reduce traumatic ICH. The aim of the present study was to investigate the
extent of ICH growth after TA administration in TBI patients.
METHODS: This single-blind randomized controlled trial was conducted on patients
with traumatic ICH (with less than 30 ml) referring to the emergency department
of Vali-Asr Hospital, Arak, Iran in 2014. Patients, based on the inclusion and
exclusion criteria, were divided into intervention and control groups (40
patients each). All patients received a conservative treatment for ICH, as well
as either intravenous TA or placebo. The extent of ICH growth as the primary
outcome was measured by brain CT scan after 48 h.
RESULTS: Although brain CT scan showed a significant increase in hemorrhage
volume in both groups after 48 h, it was significantly less in the TA group than
in the control group (p = 0.04). The mean total hemorrhage expansion was
(1.7 ± 9.7) ml and (4.3 ± 12.9) ml in TA and placebo groups, respectively
(p < 0.001).
CONCLUSION: It has been established that TA, as an effective hospital-based
treatment for acute TBI, could reduce ICH growth. Larger studies are needed to
compare the effectiveness of different doses. 

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