The Effects of Antithrombotic Therapy on Head Trauma and its Management

To examine the effects of antithrombotics for head trauma, 393 consecutive patients were enrolled. The patients were divided into those that were (group A, n = 117) and were not (group B, n = 276) taking antithrombotics, and the groups’ outcomes were compared. To identify factors that affected functional independence in group A, clinical factors were compared between the patients that exhibited mRS of 0–2 and 3–6 at discharge. Furthermore, to assess the optimal time to restart antithrombotics, cases in which rebleeding occurred after antithrombotics were restarted or thromboembolic events occurred were extracted. The ratio of mRS 3–6 and death within 30 days were significantly higher in group A than in group B. Multivariate analysis of group A revealed that being aged ≥ 70, not receiving antiplatelet therapy, and intracranial hematoma enlargement were poor prognostic factors. Five patients in group A experienced ischemic strokes within 30 days. In 3 of these patients, the ischemic strokes occurred before antithrombotics were restarted. Rebleeding occurred in two cases after anticoagulants restarted within 48 hours. Patients taking antithrombotics are at high risk of poor prognosis after head trauma. To prevent thromboembolic events, the active resumption of antithrombotics after 48 hours is desirable if hemostasis has been achieved.