What question did this study set out to answer?

This study aims to evaluate the prevalence of traumatic intracranial lesions in patients with mild traumatic brain injury undergoing antiplatelet therapy and analyze their subsequent management.

July 24, 2026BMC Emergency Medicine0 citationsOpen Access

Intracranial lesion yield and downstream management after mild traumatic brain injury in emergency department patients receiving antiplatelet therapy: a two-center retrospective cohort study

FPFatima DI PADOVA TSTifany SEKULSKI DHDounia HAMDOUCHE

Key Points

This study aims to evaluate the prevalence of traumatic intracranial lesions in patients with mild traumatic brain injury undergoing antiplatelet therapy and analyze their subsequent management.
Conducted a retrospective cohort study across two emergency departments in France.
Included adults on antiplatelet therapy presenting with mild traumatic brain injury and who underwent head CT scans.
Performed exploratory multivariable logistic regression to assess associations with intracranial lesions.
Traumatic intracranial lesions were found in 282 out of 1,912 patients (14.7%).
Among those with lesions, 82.3% were admitted or observed for 24 hours, 5.7% required neurosurgical management, and 36.9% had repeat imaging.
Adjusted odds ratios for injury mechanisms suggest specific trauma events increase the risk of intracranial lesions.

Abstract

Abstract Background Mild traumatic brain injury (mTBI) in patients receiving antiplatelet therapy is a frequent emergency department presentation. We aimed to describe the prevalence of traumatic intracranial lesions on the initial head computed tomography (CT) scan and the downstream in-hospital management of antiplatelet-treated adults with mTBI. Methods We conducted a retrospective two-center cohort study in the emergency departments of Tours and Orléans University Hospitals, France. Adults receiving antiplatelet therapy who presented with mTBI (Glasgow Coma Scale score 13–15) and underwent an initial head CT scan were included. The primary outcome was the presence of any traumatic intracranial lesion on the initial CT scan. Secondary outcomes included downstream management during the index episode. An exploratory multivariable logistic regression analysis was performed using pre-CT variables. Results A total of 1,912 patients were included; mean age was 80.8 ± 12.1 years and 52.1% were women. Traumatic intracranial lesions were identified in 282 patients (14.7%). Among patients with lesions, 232 (82.3%) underwent hospital admission or 24-hour emergency department observation, 16 (5.7%) required neurosurgical management, and 104 (36.9%) underwent repeat brain imaging. In exploratory multivariable analysis, falls above standing height or high-energy falls (adjusted odds ratio aOR 2.84, 95% confidence interval CI 1.95–4.14), other trauma mechanisms (aOR 1.82, 95% CI 1.30–2.54), motor deficit at presentation (aOR 3.71, 95% CI 1.95–6.81), facial fracture (aOR 2.25, 95% CI 1.51–3.31), and temporal impact (aOR 1.94, 95% CI 1.29–2.85) were independently associated with traumatic intracranial lesions. Conclusions In antiplatelet-treated adults with mTBI, traumatic intracranial lesions were detected in approximately one in seven patients on the initial CT scan, whereas neurosurgical intervention remained uncommon. Trauma-related clinical features appeared more informative than age alone for lesion detection.

问 AI

Bookmark

View Full Paper