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It is known that patients with severe head injury experience marked hypercoagulability and excessive hyperfibrinolysis due to the release of tissue factors from injured cerebral parenchyma. We retrospectively evaluated the usefulness of tranexamic acid (TA) in patients with single, severe head trauma, who showed a Glasgow coma scale (GCS) 8 or D-dime > or = 20 microg ml-1. Twenty-five patients receiving TA [TA (+) ] were given the agent 2 g taking 30 minutes soon after their visit. Those not receiving TA [TA (--)] were 25 consecutive patients who met the criteria before the initiation of treatment with TA. The mortality rate was 4% in TA (+) and 24% in TA (-), significantly lower than in the former. The prognosis showed a tendency to improve in TA (+), but without significant differences between the groups. D-dimer was compared between the groups with a favorable prognosis in TA (+) and those in TA (-), its value was significantly higher in the former (60+/-56 microg ml-1) than the latter (28 +/- 27 microg ml-1) group. In addition, no thrombotic complications occurred in the former. Patients with severe head injury receiving TA showed a significantly better mortality rate without complications suggesting its usefulness.


Nozomi Majima, Isao Nishihara, Keiji Yamaguchi, Makiko Kawakami. Usefulness of tranexamic acid in patients with severe head injury]. Masui. The Japanese journal of anesthesiology. 2013 Apr;62(4):410-5

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PMID: 23697191

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