Pastor Iulia-Sevastiana, Para Ioana, Vesa Ştefan Cristian, Florian Ioan Ştefan
Department of Neurosurgery, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
4 Department of Internal Medicine, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Med Pharm Rep. 2023 Jul;96(3):269-273. doi: 10.15386/mpr-2535. Epub 2023 Jul 27.
The aim of the study was to determine the impact of prior anticoagulant treatment on the characteristics of intracranial hematomas.
We included in this retrospective study 135 patients who were diagnosed with subdural hematoma in the context of traumatic brain injury. We recorded the demographic and clinical data, the paraclinical examinations and the characteristics of subdural hematoma evidenced by preoperative computed tomography (CT). We also reported the other brain injuries, entailed by primary and secondary lesions, as described by CT.
The anticoagulation therapy was recorded in 35 patients, at the moment of diagnosis. Acute subdural hematoma was recorded in 89 (65.9%) patients, 21 (60%) of these had anticoagulation therapy on admission. There were 46 (34.1%) patients with chronic subdural hematoma, 14 (40%) of these were on anticoagulant therapy. The midline shift was significantly moved in patients with anticoagulation therapy. The thickness of the subdural hematoma was significantly higher in patients with anticoagulation. We did not find any significant association of the other brain lesions (cranial fracture, extradural hematoma, intraparenchymal hematoma, nor intracranial hypertension, brain herniation, brain swelling), and the presence of anticoagulation therapy.
The study showed that anticoagulants significantly influence some neuroimaging aspects of the SDH in head trauma.
本研究旨在确定先前的抗凝治疗对颅内血肿特征的影响。
我们纳入了这项回顾性研究中的135例在创伤性脑损伤背景下被诊断为硬膜下血肿的患者。我们记录了人口统计学和临床数据、辅助检查以及术前计算机断层扫描（CT）显示的硬膜下血肿特征。我们还报告了CT描述的由原发性和继发性病变引起的其他脑损伤。
35例患者在诊断时接受了抗凝治疗。89例（65.9%）患者记录为急性硬膜下血肿，其中21例（60%）入院时接受了抗凝治疗。46例（34.1%）患者为慢性硬膜下血肿，其中14例（40%）接受了抗凝治疗。接受抗凝治疗的患者中线移位明显。接受抗凝治疗的患者硬膜下血肿厚度明显更高。我们未发现其他脑损伤（颅骨骨折、硬膜外血肿、脑实质内血肿、颅内高压、脑疝、脑肿胀）与抗凝治疗的存在之间有任何显著关联。
该研究表明，抗凝剂对头外伤中硬膜下血肿的一些神经影像学方面有显著影响。
