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Platelet Dysfunction after Traumatic Brain Injury: A Review.

Christina M Riojas1, Michael L Ekaney1, Samuel W Ross1

  • 1FH "Sammy" Ross Trauma Center, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.

Journal of Neurotrauma
|November 4, 2020
PubMed
Summary

Platelet dysfunction is common after traumatic brain injury (TBI) and may worsen outcomes. Platelet function assays can help guide treatment, potentially improving patient care.

Keywords:
coagulopathyplatelet dysfunctionplatelet function assayplatelet inhibitor therapyplatelet transfusiontraumatic brain injury

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Area of Science:

  • Neuroscience
  • Hematology
  • Trauma Surgery

Background:

  • Coagulopathy is a frequent complication of traumatic brain injury (TBI), increasing patient morbidity and mortality.
  • Platelet dysfunction is a significant contributor to TBI-related coagulopathy, often linked to adverse patient outcomes.
  • Accurate detection and monitoring of platelet function are crucial for managing TBI patients, irrespective of the underlying cause of dysfunction.

Purpose of the Study:

  • To review the existing literature and clarify the incidence and clinical significance of platelet dysfunction following TBI.
  • To provide evidence-based recommendations for the evaluation and management of platelet dysfunction in TBI patients.
  • To highlight the need for further research, including randomized trials, to improve clinical practice.

Main Methods:

  • A comprehensive literature review was conducted.
  • 348 abstracts were initially screened, with 97 manuscripts included in the final analysis.
  • The review focused on studies investigating platelet dysfunction in the context of TBI.

Main Results:

  • Platelet dysfunction is consistently observed in patients with moderate to severe TBI.
  • Platelet function assays are recommended for evaluating TBI patients.
  • Platelet transfusion may be a beneficial intervention for TBI-related platelet dysfunction.

Conclusions:

  • Platelet dysfunction is a significant issue in TBI patients, necessitating careful monitoring and management.
  • The use of platelet function assays can aid in patient-specific treatment planning.
  • Further research, particularly randomized controlled trials, is needed to establish evidence-based guidelines for platelet transfusion in TBI.