Head Injury Updates

The last time we took a good look at head injuries was back in 2018 in our Roadside to Resus episodes and for all of the foundational stuff on incidence, assessment, management and loads more  make sure you go and check that episode out. 

But this episode is one of our new UPDATES episodes, because we’re pretty old now… and whilst we’ve been having a go at this for a while evidence and guidelines will have progressed, which clearly have implications on how we manage certain cases and that’s where these come in! So they’ll focus mainly on the last 5 years of practice.

The new NICE head injury guidance has just been released and it’s the first major overhaul since 2014.  Now we know it’s a UK guideline, but there’s some really key practice updates and evidence in there that’s relevant irrespective of where you find yourself listening this! 

So in this episode we’re going to be having a look at the most recent TXA evidence, with in terms of indications, timing and dosing. We’ll be having a look at the risk of intracerebral injury with regards to anticoagulants and antiplatelet agents and a few other bits and pieces that can help us inform and improve our care.

Once again we’d love to hear any comments or questions either via the website or social media.

Enjoy!

Simon, Rob & James

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References

NICE Head Injury Guidelines. 2023

Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury. Susan E Rowell. JAMA. 2020

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. CRASH-3 trial collaborators. 2019

Hypopituitarism After Traumatic Brain Injury. Sanjiv Gray. Cureus. 2019

Hypopituitarism Following Traumatic Brain Injury: Determining Factors for Diagnosis. Eva Fernandez-Rodriguez. Front Endocrinol (Lausanne). 2011

The screening and management of pituitary dysfunction following traumatic brain injury in adults: British Neurotrauma Group guidance. Neurology, Neurosurgery & Psychiatry. 2017

The Resus Room; October 2020 Papers of the month

Risk of significant traumatic brain injury in adults with minor head injury taking direct oral anticoagulants: a cohort study and updated meta-analysis. Gordon Fuller. Emerg Med J. 2020

AHEAD Study: an observational study of the management of anticoagulated patients who suffer head injury. Mason. BMJ. 2017

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