Transarterial embolisation for intractable post-traumatic oronasal haemorrhage following traumatic brain injury: evaluation of prognostic factors.

AIM

To analyse the outcomes of transarterial embolisation (TAE) for post-traumatic oronasal haemorrhage following traumatic brain injury (TBI), for clinical application and prognosis.

METHOD

Retrospective review of records of 17 patients treated in the neurosurgical intensive care unit for TBI complicated with intractable post-traumatic oronasal haemorrhage requiring TAE. The Mann-Whitney U-test, Wilcoxon signed rank test and Fisher's exact test were used in statistical analysis.

RESULTS

TAE successfully stopped the post-traumatic oronasal haemorrhage in 13 of 17 cases. The internal maxillary artery was the most common haemorrhaging vessel requiring embolisation. Successful haemostasis contributed significantly to survival.

CONCLUSION

Transarterial embolisation may stop intractable post-traumatic oronasal haemorrhage when conventional packing fails. Shock index (calculated as heart rate/systolic blood pressure) before and after TAE <1.2 and <0.8, respectively, and higher Glasgow Coma Scale (>8) before than after TAE, were positively correlated with survival.