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Coagulopathy in traumatic brain injury
Sherman C Stein1, Douglas H Smith
1Department of Neurosurgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. sherman.stein@uphs.upenn.edu
Neurocritical Care
|September 22, 2005
Summary
Traumatic brain injury (TBI) often causes blood coagulation abnormalities, likely due to disseminated intravascular coagulation (DIC). This may explain cerebral ischemia and offers targets for new therapies.
Area of Science:
- Neurology
- Hematology
- Trauma Research
Background:
- Coagulopathy is common after traumatic brain injury (TBI) but its significance remains unclear.
- Existing research suggests a link between post-TBI coagulopathy and secondary brain injury.
Purpose of the Study:
- To review the clinical and pathophysiological features of post-TBI coagulation abnormalities.
- To explore the connection between TBI, disseminated intravascular coagulation (DIC), and cerebral ischemia.
- To identify potential therapeutic strategies for mitigating TBI-related coagulopathy.
Main Methods:
- Literature review of clinical and pathophysiological features of TBI-associated coagulopathy.
- Analysis of research findings supporting the link between DIC and cerebral ischemia post-TBI.
- Discussion of potential therapeutic avenues based on the understanding of DIC in TBI.
Main Results:
- Disseminated intravascular coagulation (DIC) is a frequent and significant consequence of TBI.
- Posttraumatic coagulopathy is strongly associated with secondary cerebral injury.
- Coagulation abnormalities are detectable early after trauma, enabling risk stratification.
Conclusions:
- DIC provides a plausible explanation for cerebral ischemia following TBI, specifically via intravascular microthrombosis.
- Early identification of coagulopathic patients allows for timely intervention and evaluation of novel therapies.
- Further intensive research is warranted to fully elucidate and manage post-TBI coagulopathy.