title: The effect of tranexamic acid in traumatic brain injury: A randomized controlled trial.
abstract: OBJECTIVE
  Traumatic brain injury (TBI) is a leading cause of death and disability. Intracranial hemorrhage (ICH) secondary to TBI is associated with a high risk of coagulopathy which leads to increasing risk of hemorrhage growth and higher mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid (TA) might reduce traumatic ICH. The aim of the present study was to investigate the extent of ICH growth after TA administration in TBI patients.
  
  
  METHODS
  This single-blind randomized controlled trial was conducted on patients with traumatic ICH (with less than 30 ml) referring to the emergency department of Vali-Asr Hospital, Arak, Iran in 2014. Patients, based on the inclusion and exclusion criteria, were divided into intervention and control groups (40 patients each). All patients received a conservative treatment for ICH, as well as either intravenous TA or placebo. The extent of ICH growth as the primary outcome was measured by brain CT scan after 48 h.
  
  
  RESULTS
  Although brain CT scan showed a significant increase in hemorrhage volume in both groups after 48 h, it was significantly less in the TA group than in the control group (p = 0.04). The mean total hemorrhage expansion was (1.7 ± 9.7) ml and (4.3 ± 12.9) ml in TA and placebo groups, respectively (p < 0.001).
  
  
  CONCLUSIONS
  It has been established that TA, as an effective hospital-based treatment for acute TBI, could reduce ICH growth. Larger studies are needed to compare the effectiveness of different doses.
authors.affiliation: Department of Emergency Medicine, Arak University of Medical Science, Arak, Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Jokar
authors.affiliation: Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Ahmadi
authors.affiliation: Department of Emergency Medicine, Arak University of Medical Science, Arak, Iran.
authors.forename: Tayyebeh
authors.initials: T
authors.lastname: Salehi
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sharif-Alhoseini
authors.affiliation: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: v_rahimi@sina.tums.ac.ir.
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D020202:Cerebral Hemorrhage, Traumatic / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Intracranial hemorrhage; Tranexamic acid; Traumatic; Traumatic brain injuries