[Coagulation disorders in patients with trauma to the skull and brain: a frequent and potentially fatal combination].
Abnormalities in blood coagulation are relatively common after traumatic brain injury (TBI) and play an important role in the morbidity and mortality after head injuries. Exposure oftissue factor, which is abundantly present in brain tissue, is the initiator of the coagulation cascade and plays an important role in the pathogenesis of coagulopathy after TBI. Coagulopathy after TBI is actually a manifestation of the disseminated intravascular coagulation (DIC) syndrome. The interplay between hypothermia, acidosis and progressive coagulopathy, referred to as the 'lethal triad', results in high mortality. This necessitates damage control in the treatment of such TBI patients. Repeated laboratory evaluation of the coagulation parameters in TBI patients is indicated, even if the initial values are normal. The DIC score, a combination of frequently used coagulation parameters, is not only a measure of the coagulopathy but can also predict the outcome and prognosis following TBI. Primary and secondary prevention of coagulopathy together with timely and effective intervention are the most important elements in the treatment of coagulation disorders. Nevertheless, the risk of death remains high.
Haagh
W A J J M
WA
Afd. Chirurgie en Traumatologie, Academisch Ziekenhuis Maastricht, Postbus 5800, 6202 AZ Maastricht. w.haagh@surgery.azm.nl
van Pampus
E C M
EC
van Zutphen
S W A M
SW
Brink
P R G
PR
D001777:Blood Coagulation; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality; D003029:Coagulants / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D006801:Humans
D003029:Coagulants