Warfarin
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Delayed intracranial haemorrhage: 10 case reports In a retrospective study of 423 patients, who were receiving anticoagulation treatment and presented to level-1 trauma centres in the USA between 2016 and 2018 with possible traumatic brain injuries, 7 men and 3 women aged 50 years–95 years were described, who developed delayed intracranial haemorrhage during anticoagulation treatment with warfarin. The patients, who were receiving anticoagulation treatment with oral warfarin [dosages not stated] presented with suspected traumatic brain injury following a fall (9 patients) and motor vehicle collision (one patient). At the time of the presentation, their international normalised ratio was between 1.0 and 3.9. Initial head CT scan of all the 10 patients was negative for acute haemorrhage. However, approximately 6 hours later a repeat head CT scan revealed delayed intracranial haemorrhage. The delayed intracranial haemorrhage was attributed to the ongoing warfarin treatment [durations of treatments to reactions onsets not stated]. Eight out of the 10 patients started receiving anticoagulation reversal agents including vitamin K (2 patients), prothrombin complex concentrate (PCC; one patient), vitamin K and prothrombin complex concentrate (3 patients) and vitamin K and plasma [fresh frozen plasma (FFP); 2 patients]. Two patients were admitted and underwent neurosurgical intervention; external ventricular drain (one patient) and craniectomy (one patient). Out of 10 patients, two patients died despite the treatments after development of delayed intracranial haemorrhage [not all outcomes stated]. Cohan CM, et al. Repeat computed tomography head scan is not indicated in trauma patients taking novel anticoagulation: A multicenter study. The Journal of Trauma and 803518054 Acute Care Surgery 89: 301-310, No. 2, Aug 2020. Available from: URL: http://doi.org/10.1097/TA.0000000000002760
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Reactions 28 Nov 2020 No. 1832
