[Coagulation disorders in traumatic brain injuries]

Exposure of subendothelial collagen and release of tissue thromboplastin render possible activation of both the internal and external coagulation cascades in traumatic lesions of the brain. Disseminated intravascular coagulation (DIC) is well described in brain lesions and may contribute to the haemorrhagic tendency in brain-injured patients. DIC is also suggested as a contributory factor for the degree of secondary brain damage and the development of pulmonary complications and tardive intracranial haematomata. The literature concerning DIC and traumatic brain damage is, however, difficult to assess as many of the materials include multitraumatized patients and the diagnostic criteria for DIC vary. In addition, it is difficult to differentiate between normal physiological phenomena and genuine pathological processes. No controlled and randomized investigations concerning the effects of specific antithrombotic treatment of DIC in traumatic lesions of the brain are available. It is recommended that patients with brain injuries should be examined for the development of disturbances of coagulation and that the relevant laboratory investigations should be included in assessment of this patient group.