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Choice of Antiplatelet vs. Anticoagulant for Blunt Cerebrovascular Injury

Denise Baloi1, Yusor Al-Nuaimy2, Ammar Saloum1

  • 1College of Human Medicine, Michigan State University, Lansing, MI 48823, USA.

Life (Basel, Switzerland)
|September 27, 2025
PubMed

Insights

Blunt cerebrovascular injury (BCVI) affects 2.4% of trauma patients, risking stroke. This review examines antiplatelet and anticoagulant treatments for BCVI from 2015-2025.

Area of Science:

  • Trauma Surgery
  • Neurology
  • Vascular Medicine

Background:

  • Blunt cerebrovascular injury (BCVI) is a common trauma complication affecting ~2.4% of patients.
  • Untreated BCVI can lead to stroke and permanent neurological deficits.
  • Increased CT angiography use has raised BCVI diagnosis rates in TBI and polytrauma.

Purpose of the Study:

  • To review current evidence (2015-2025) on best practices for BCVI treatment.
  • To explore the role of antiplatelet and anticoagulant therapies in managing BCVI.
  • To provide an updated understanding of mitigating BCVI-related morbidity.

Main Methods:

  • Systematic literature review of studies published between 2015 and 2025.
  • Analysis of evidence regarding antiplatelet agents (aspirin, P2Y12 inhibitors) and anticoagulants (warfarin, DOACs).
  • Evaluation of treatment outcomes and complication rates associated with different therapeutic strategies.

Main Results:

  • Evidence supports the use of antiplatelet and anticoagulant medications in BCVI management.
  • Specific agents like aspirin, P2Y12 inhibitors, warfarin, and DOACs show varying efficacy.
  • Optimal treatment selection depends on injury severity and patient-specific factors.

Conclusions:

  • Current evidence guides the use of antiplatelet and anticoagulant therapies for BCVI.
  • Further research may refine treatment protocols for optimal patient outcomes.
  • Effective management of BCVI is crucial for reducing stroke and neurological deficits.

Keywords:
BCVIanticoagulant therapyantiplatelet therapyantiplatelet versus anticoagulantblunt cerebrovascular injury

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