PMID- 35006097
OWN - NLM
STAT- MEDLINE
DCOM- 20220720
LR  - 20230322
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 90
IP  - 3
DP  - 2022 Mar 1
TI  - Does Pre-existing Anticoagulation or Antiplatelet Therapy Increase the Risk of 
      Traumatic Subarachnoid Hemorrhage Progression?
PG  - 300-305
LID - 10.1227/NEU.0000000000001791 [doi]
AB  - BACKGROUND: Isolated traumatic subarachnoid hemorrhage (tSAH) is a common finding 
      in mild traumatic brain injury that often results in transfer to a tertiary 
      center. Patients prescribed blood-thinning medications (BTs) are believed to be 
      at higher risk of clinical or radiographic worsening. OBJECTIVE: To compare the 
      rates of radiographic progression and need for neurosurgical intervention in 
      patients with tSAH who are on anticoagulation (AC) and antiplatelet (AP) 
      therapies with those who are not. METHODS: Analysis using a retrospective cohort 
      design identified patients older than 18 years with isolated tSAH and a Glasgow 
      Coma Scale of 15 on admission. Clinical information including use of BTs, 
      administration of reversal agents, radiographic progression, and need for 
      neurosurgical intervention was collected. Patients on BTs were divided into AP, 
      AC, and AP/AC groups based on drug type. RESULTS: Three hundred eighty-four 
      patients were included with 203 in the non-BT group and 181 in the BT group. 
      Overall, 2.1% had worsening scans, and none required operative intervention. 
      There was no difference in radiographic worsening between the non-BT and BT 
      groups (2.4% vs 1.6%; P = 1.00). Crosswise comparison revealed no difference 
      between the non-BT group and each BT subtype (AP, AP/AC, or AC). The non-BT group 
      was more likely to have radiographic improvement than the BT group (45.8% vs 
      30.9%; P = .002). CONCLUSION: Neurologically intact patients on BTs with isolated 
      tSAH are not at increased risk of radiographic progression or neurosurgical 
      intervention. The presence of BTs should not influence management decisions for 
      increased surveillance.
CI  - Copyright (c) Congress of Neurological Surgeons 2021. All rights reserved.
FAU - Harland, Tessa A
AU  - Harland TA
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Prabhala, Tarun
AU  - Prabhala T
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Nardolillo, AnneMarie
AU  - Nardolillo A
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Dalfino, John C
AU  - Dalfino JC
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Adamo, Matthew A
AU  - Adamo MA
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Paul, Alexandra R
AU  - Paul AR
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Boulos, Alan S
AU  - Boulos AS
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
FAU - Entezami, Pouya
AU  - Entezami P
AUID- ORCID: 0000-0003-0208-049
AD  - Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
AD  - Department of Pharmacy, Albany Medical Center, Albany, New York, USA.
LA  - eng
PT  - Journal Article
DEP - 20211224
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Retrospective Studies
MH  - *Subarachnoid Hemorrhage
MH  - *Subarachnoid Hemorrhage, Traumatic
EDAT- 2022/01/11 06:00
MHDA- 2022/07/22 06:00
CRDT- 2022/01/10 12:21
PHST- 2021/06/15 00:00 [received]
PHST- 2021/09/27 00:00 [accepted]
PHST- 2022/01/11 06:00 [pubmed]
PHST- 2022/07/22 06:00 [medline]
PHST- 2022/01/10 12:21 [entrez]
AID - 00006123-202203000-00007 [pii]
AID - 10.1227/NEU.0000000000001791 [doi]
PST - ppublish
SO  - Neurosurgery. 2022 Mar 1;90(3):300-305. doi: 10.1227/NEU.0000000000001791. Epub 
      2021 Dec 24.