John Batchelor
Central Manchester Foundation Trust, UK
Title: The management of traumatic intracranial hemorrhage in patients taking pre-injury antiplatelet agents: An update
Biography
Biography: John Batchelor
Abstract
With an ever increasing elderly population, falls in the elderly is a common condition presenting on a daily basis to Emergency departments. Many of these elderly fallers will have head injuries and will be taking antiplatelet agents, notably aspirin. The risk of traumatic intracranial hemorrhage is increased in patients taking antiplatelet agents although the risk is less than that of warfarin (odds ratio of 2.5 versus 1.5). The risk of mortality in patients’ taking aspirin with traumatic brain injury is slightly increased in patients on antiplatelet agents in contrast to warfarin where the mortality is doubled. On the basis of this level of evidence some clinicians advocate the use of a platelet transfusion in patients with traumatic brain hemorrhage who are on antiplatelet agents. The evidence for this will be reviewed. Desmopressin is an alternative agent which might have a potential role in this area. Finally the role of platelet function assays will be reviewed based upon the current research evidence in this area.