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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com


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viernes, 9 de noviembre de 2012

Trauma craneal en pacientes anticoagulados

Management of Minor Head Injury in Patients Receiving Oral Anticoagulant Therapy: A Prospective Study of a 24-Hour Observation Protocol
Menditto V y col. Ann Emerg Med 2012; 59(6): 451-455 

Editor’s Capsule Summary
"What is already known on this topic: Computed tomography (CT) scanning is typical for patients with minor head injury and receiving warfarin. Subsequent management, however, is controversial.
What question this study addressed: Does a protocol of 24-hour observation followed by a repeated head CT scan detect delayed bleeding?
What this study adds to our knowledge: Repeated CT scanning revealed new hemorrhages in 5 of 87 patients completing the protocol, with 1 undergoing craniotomy. Two patients discharged after the protocol (both with international normalized ratio 3.0) were later readmitted with bleeding, but neither required surgery.
How this is relevant to clinical practice: Delayed intracranial hemorrhage is common after minor head injury when patients are receiving warfarin. A minimum protocol of 24-hour observation followed by repeated scanning is necessary to detect most such occurrences."