title: Antiplatelet therapy: a double-edged sword in head injury?
abstract: Antiplatelet therapy for the treatment of cardiovascular diseases is common in the ageing population. Whether this therapy exacerbates brain injury after head trauma is an important, but unsettled, topic. In this issue of Critical Care, Fabbri and colleagues address the question of whether pre-injury intake of antiplatelet medication increases the risk profile of patients with posttraumatic intracranial lesions after head trauma. Antiplatelet medication, and in particular clopidogrel, increased the risk for haematoma progression, need for neurosurgical intervention and an unfavourable outcome. Clinicians should consider this increased risk profile in the treatment of respective patients. Since its introduction as an analgesic in 1897, aspirin has surprised the medical community more than once due to its versatile properties. Prevention of secondary brain damage through aspirin has been reported for ischaemic stroke and subarachnoid haemorrhage. In cases of acute traumatic haemorrhage after head injury, antiplatelet therapy's neuroprotective effects may be outweighed by the increased bleeding tendency.
authors: Christopher
authors: C
authors: Beynon
authors: Oliver W
authors: OW
authors: Sakowitz
mesh_terms: D006259:Craniocerebral Trauma / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors
references: Crit Care. 2013 Mar 21;17(2):R53
references: 23514619
references: J Neurotrauma. 2010 Jan;27(1):121-30
references: 19803784
references: Emerg Med J. 2009 Dec;26(12):871-6
references: 19934132
references: Thromb Res. 2012 Jan;129(1):3-8
references: 21907395
references: J Neurochem. 2005 Jun;93(6):1587-93
references: 15935075
references: Crit Care Med. 2013 Feb;41(2):399-404
references: 23263579
references: Crit Care. 2012 Jul 26;16(4):228
references: 22839302
references: Br J Neurosurg. 2013 Feb;27(1):12-8
references: 22900511
references: Neurosurgery. 2012 Jun;70(6):1334-45
references: 22307074