Abstract
Background
Anticoagulated patients have increased risk for bleeding, and serious outcomes could
occur after head injury. Controversy exists regarding the utility of head computed
tomography (CT) in allowing safe discharge dispositions for anticoagulated patients
suffering minor head injury.
Clinical Question
What is the risk of delayed intracranial hemorrhage in anticoagulated patients with
minor head injury and a normal initial head CT scan?
Evidence Review
Four observational studies were reviewed that investigated the outcomes of anticoagulated
patients who presented after minor head injury.
Results
Overall incidence of death or neurosurgical intervention ranged from 0 to 1.1% among
the patients investigated. The studies did not clarify which patients were at highest
risk.
Conclusion
The literature does not support mandatory admission for all anticoagulated patients
after minor head injury, but further studies are needed to identify the higher-risk
patients for delayed bleeding to determine appropriate management.
Keywords
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Article info
Publication history
Published online: December 20, 2013
Accepted:
August 18,
2013
Received:
April 27,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
