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• W3040371077 endingPage "656" @default.
• W3040371077 startingPage "635" @default.
• W3040371077 abstract "Abstract Almost two-thirds of patients with severe traumatic brain injury (TBI) develop some form of hemostatic disturbance, which contributes to poor outcome. While the initial head injury often leads to impaired clot formation, TBI is also associated with an increased risk of thrombosis. Most likely there is a progression from early bleeding to a later prothrombotic state. In this paper, we systematically review the literature on the time course of hemostatic disruptions following TBI. A MEDLINE search was performed for TBI studies reporting the trajectory of hemostatic assays over time. The search yielded 5,049 articles, of which 4,910 were excluded following duplicate removal as well as title and abstract review. Full-text assessment of the remaining articles yielded 33 studies that were included in the final review. We found that the first hours after TBI are characterized by coagulation cascade dysfunction and hyperfibrinolysis, both of which likely contribute to lesion progression. This is then followed by platelet dysfunction and decreased platelet count, the clinical implication of which remains unclear. Later, a poorly defined prothrombotic state emerges, partly due to fibrinolysis shutdown and hyperactive platelets. In the clinical setting, early administration of the antifibrinolytic agent tranexamic acid has proved effective in reducing head-injury-related mortality in a subgroup of TBI patients. Further studies evaluating the time course of hemostatic disruptions after TBI are warranted in order to identify windows of opportunity for potential treatment options." @default.
• W3040371077 created "2020-07-10" @default.
• W3040371077 creator A5009704900 @default.
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• W3040371077 creator A5082953939 @default.
• W3040371077 date "2020-06-30" @default.
• W3040371077 modified "2023-10-18" @default.
• W3040371077 title "Time Course of Hemostatic Disruptions After Traumatic Brain Injury: A Systematic Review of the Literature" @default.
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• W3040371077 doi "https://doi.org/10.1007/s12028-020-01037-8" @default.
• W3040371077 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8128788" @default.
• W3040371077 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/32607969" @default.
• W3040371077 hasPublicationYear "2020" @default.
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