PMID- 33636220
OWN - NLM
STAT- MEDLINE
DCOM- 20230130
LR  - 20230202
IS  - 0150-9861 (Print)
IS  - 0150-9861 (Linking)
VI  - 50
IP  - 1
DP  - 2023 Feb
TI  - Limited benefit of systematic head CT for mild traumatic brain injury in patients 
      under antithrombotic therapy.
PG  - 30-35
LID - S0150-9861(21)00045-6 [pii]
LID - 10.1016/j.neurad.2021.02.004 [doi]
AB  - BACKGROUND AND PURPOSE: Mild traumatic brain injury (mTBI) in patients on 
      antiplatelet (AP), anticoagulant (AC) or direct oral anticoagulant (DOAC) 
      medication has become a systematic indication for head CT. However, the over-risk 
      and impact of the intracranial hemorrhages (IH) detected with CT in this 
      population remain unclear and need to be assessed. MATERIALS AND METHODS: We 
      prospectively assessed head CTs performed in adults taking AP/AC/DOAC referred 
      after a mTBI to our Emergency Departments between September 2016 and January 
      2018. Frequency, type and severity of IH were described and frequency was 
      analyzed as a function of treatment. RESULTS: 840 patients were prospectively 
      included. 58.9% were treated with AP, 23.7% with AC, 11.7% with DOAC and 5.7% 
      with a combination of antithrombotic agents. The rate of IH detected with head CT 
      was 5.8% (n...=...49), of which 81.6% (n...=...40) and 18.4% (n...=...9) with 
      minor and intermediate severity respectively. No patient required surgical care 
      and no death occurred. No statistically significant difference was found in 
      treatment distribution between patients with or without IH (p...=...0.98). Among 
      the patients who discontinued their antithrombotic treatment after mTBI, three 
      experienced thrombotic events during the hospitalization. CONCLUSIONS: Our 
      results showed a low frequency and severity of IH in mTBI patients indifferently 
      treated with AP, AC or DOAC, without secondary neurological deterioration, death 
      or need of surgical care. Our study suggests the limited benefit of systematic CT 
      head scan as a standard practice for the management of mTBI patients under 
      antithrombotic therapy.
CI  - Copyright (c) 2021 Elsevier Masson SAS. All rights reserved.
FAU - Colas, Lucie
AU  - Colas L
AD  - Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, 
      Lille, France. Electronic address: Colas.Lucie@ghicl.net.
FAU - Graf, Sahara
AU  - Graf S
AD  - Biostatistics Department ... Delegation for Clinical Research and Innovation, 
      Lille Catholic Hospitals, Lille Catholic University, F-59000, Lille, France. 
      Electronic address: Graf.Sahara@ghicl.net.
FAU - Ding, Juliette
AU  - Ding J
AD  - Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, 
      Lille, France. Electronic address: Ding.Juliette@ghicl.net.
FAU - Bertolotti, Gregory
AU  - Bertolotti G
AD  - Emergency Department, Lille Catholic Hospitals, Lille Catholic University, 
      F-59000, Lille, France. Electronic address: Bertolotti.Gregory@ghicl.net.
FAU - Thellier, Nicolas
AU  - Thellier N
AD  - Emergency Department, Lille Catholic Hospitals, Lille Catholic University, 
      F-59000, Lille, France. Electronic address: Thellier.Nicolas@ghicl.net.
FAU - Budzik, Jean-Fran Ois
AU  - Budzik JO
AD  - Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, 
      Lille, France. Electronic address: Budzik.Jean-Francois@ghicl.net.
FAU - Verclytte, Sebastien
AU  - Verclytte S
AD  - Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, 
      Lille, France. Electronic address: Verclytte.Sebastien@ghicl.net.
LA  - eng
PT  - Journal Article
DEP - 20210223
PL  - France
TA  - J Neuroradiol
JT  - Journal of neuroradiology = Journal de neuroradiologie
JID - 7705086
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Brain Concussion/chemically induced/drug therapy
MH  - Fibrinolytic Agents/therapeutic use
MH  - Retrospective Studies
MH  - Anticoagulants/therapeutic use
MH  - Intracranial Hemorrhages
MH  - Tomography, X-Ray Computed
OTO - NOTNLM
OT  - Anticoagulants
OT  - Mild traumatic brain injury
OT  - Platelet aggregation inhibitors
OT  - Spiral computed
OT  - Tomography
OT  - Traumatic cerebral hemorrhage
EDAT- 2021/02/27 06:00
MHDA- 2023/01/31 06:00
CRDT- 2021/02/26 20:10
PHST- 2020/06/27 00:00 [received]
PHST- 2021/02/16 00:00 [revised]
PHST- 2021/02/16 00:00 [accepted]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2023/01/31 06:00 [medline]
PHST- 2021/02/26 20:10 [entrez]
AID - S0150-9861(21)00045-6 [pii]
AID - 10.1016/j.neurad.2021.02.004 [doi]
PST - ppublish
SO  - J Neuroradiol. 2023 Feb;50(1):30-35. doi: 10.1016/j.neurad.2021.02.004. Epub 2021 
      Feb 23.