In many cases the most dangerous aspect of traumatic brain injuries is not the initial injury, but rather the cascade of effects it sets off within the brain and body which can create fatal results. One of the most common complications triggered by this cascade of secondary injury is the risk of blood clots that can form in the circulatory system.
Patients with TBI often see their body form blood clots, and if these clots break loose they can travel to the lungs or other areas with lethal consequences. Doctors have feared trying to treat these clots with traditional methods for managing blood clots because another hallmark complication of severe traumatic brain injuries is the risk of bleeding inside the brain. However, a new study suggests those traditional methods may in fact work just fine on TBI patients.
A new report published in the Journal of Neurosurgery from the University of Missouri School of Medicine suggests that blood-thinning drugs can be used to treat patients with TBI to reduce the risk of potentially lethal blood clots without increasing the risk of bleeding within the brain, as Futurity reports.
“Our study found that treating traumatic brain-injured patients with an anticoagulant, or blood-thinning medication, is safe and decreases the risk of these dangerous clots,” says N. Scott Litofsky, chief of the University of Missouri School of Medicine’s Division of Neurological Surgery and director of neuro-oncology and radiosurgery at MU Health Care.
“We found that patients treated with preventive blood thinners had a decreased risk of deep-vein blood clots and no increased risk of intracranial hemorrhaging.”
In 2009, Litofsky worked with study co-author Stephen Barnes, acute care surgeon and chief of the Division of Acute Care Surgery, to create a new protocol for treating head trauma patients using blood-thinning medications.
“One of the main challenges in treating patients with traumatic brain injuries is balancing the risk of intracranial bleeding with the risk of blood clots formed elsewhere in the body,” Litofsky says.
In this new study, the researchers compared the results of 107 TBI patients who were treated before the new protocol was enacted with the outcomes of 129 patients who were treated with blood-thinning medications. While six patients who did not receive blood thinners experienced deep-venous clotting, there were zero instances of the condition in patients who received the medication.
“Based on our results, we will continue to follow the new protocol in our trauma center, and we believe that other trauma centers would benefit from adopting a similar protocol in their practice,” Litofsky says. “If we look at this issue across the country, we should hopefully see this complication occurring less often in brain-injured patients.”