Title:Intravenous Tranexamic Acid for Subdural and Epidural Intracranial Hemorrhage: Randomized, Double‐Blind, Placebo-Controlled Trial
Volume: 14
Issue: 4
Author(s): Pouya Ebrahimi, Javad Mozafari*, Reza Bahrami Ilkhchi, Mohammad Ghasem Hanafi and Maryam Mousavinejad
Affiliation:
- Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran
Keywords:
Emergency medicine, intraparenchymal hemorrhage, tranexamic acid, trauma, clinical trial, hemoglobin (Hb).
Abstract:
Background: Recovery of patients with traumatic brain injury largely depends on the
reduction in secondary brain damage. The present study aims at investigating the effect of
Tranexamic Acid (TXA) administration within the first hours of brain trauma in the emergency
department (ED).
Methods: This randomized, double-blind, placebo-controlled clinical trial was carried out in patients
with subdural and epidural hemorrhage. Patients with any type of bleeding were assigned into two
groups of TXA and 0.9% normal saline as placebo. The rate of intracranial hemorrhage after surgery
was assessed by CT-scan and amount of hemoglobin (Hb) was measured immediately before surgery
and after 6 hours of surgery.
Results: A total of 80 participants were randomly assigned into four groups of 20 people. There was
a significant difference in the mean of intraoperative bleeding during surgery in patients receiving
TXA and placebo in both SDH (Subdural hematoma) and EDH (Epidural Hemorrhage) groups (P=
0.012). The Hb drop amount had no significant difference with placebo (P< 0.0001). No
complications were observed in any of the intervention and control groups during the study as well.
Conclusion: The use of TXA may reduce bleeding, however, based on the results of this study, such
effect was not statistically significant in controlling the epidural and subdural hemorrhage, but
clinical trials with a higher sample size are suggested for further investigation in this regard.
