Review
Immunology
Zhimin Zou, Li Li, Nadine Schafer, Qiaobing Huang, Marc Maegele, Zhengtao Gu
Summary: TBI, a leading cause of death and disability worldwide, has been associated with damage to the endothelial glycocalyx which plays a crucial role in maintaining the balance between blood coagulation and anticoagulation. Recent advances in analytical techniques have made it possible to conduct biochemical, visual, and computational investigations on this vascular component.
JOURNAL OF NEUROINFLAMMATION
(2021)
Article
Neurosciences
Wenxing Cui, Xun Wu, Dayun Feng, Jianing Luo, Yingwu Shi, Wei Guo, Haixiao Liu, Qiang Wang, Liang Wang, Shunnan Ge, Yan Qu
Summary: This study reveals a significant causal role of acrolein in TBI-induced coagulopathy and vascular leakage, partly through activating the autophagy pathway and affecting endothelial cell integrity by disrupting the blood-brain barrier. Acrolein, as a potential therapeutic target, may contribute to early hypercoagulability after TBI by regulating VWF secretion.
NEUROSCIENCE BULLETIN
(2021)
Article
Medicine, General & Internal
Takeshi Wada, Atsushi Shiraishi, Satoshi Gando, Kazuma Yamakawa, Seitaro Fujishima, Daizoh Saitoh, Shigeki Kushimoto, Hiroshi Ogura, Toshikazu Abe, Toshihiko Mayumi, Junichi Sasaki, Joji Kotani, Naoshi Takeyama, Ryosuke Tsuruta, Kiyotsugu Takuma, Shin-ichiro Shiraishi, Yasukazu Shiino, Taka-aki Nakada, Kohji Okamoto, Yuichiro Sakamoto, Akiyoshi Hagiwara, Satoshi Fujimi, Yutaka Umemura, Yasuhiro Otomo
Summary: Coagulofibrinolytic changes in patients with iTBI and non-TBI were identical and consistent with the pathophysiology of DIC. DIC diagnosis in the early phase of TBI is key in predicting the outcomes of severe TBI.
FRONTIERS IN MEDICINE
(2021)
Article
Medicine, General & Internal
Fan Yang, Chi Peng, Liwei Peng, Jian Wang, Yuejun Li, Weixin Li
Summary: This study aimed to predict the risk of coagulopathy in TBI-IC patients using machine learning models. Analysis of 15 predictors led to the development and validation of models, with the Adaptive Boosting and Extreme Gradient Boosting models showing superior predictive performance.
FRONTIERS IN MEDICINE
(2021)
Review
Medicine, General & Internal
Fabian Kockelmann, Marc Maegele
Summary: Due to the aging population, the number of low falls in elderly people with pre-existing anticoagulation is increasing, leading to traumatic brain injury (TBI) with a social and economic burden. Hemostatic disorders and imbalances seem to play a significant role in bleeding progression. The interrelationships between anticoagulation medication, coagulopathy, and bleeding progression show promise for therapy.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Emergency Medicine
Gaku Fujiwara, Yohei Okada, Wataru Ishii, Ryoji Iizuka, Mamoru Murakami, Takehiko Sakakibara, Tarumi Yamaki, Naoya Hashimoto
Summary: The study found that skull fracture is associated with in-hospital mortality among patients with severe traumatic brain injury, and patients with both skull base and skull vault fractures have a higher mortality rate.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Medicine, General & Internal
Yuhui Chen, Jun Tian, Bin Chi, Shangming Zhang, Liangfeng Wei, Shousen Wang
Summary: The incidence of coagulopathy after open traumatic brain injury (TBI) is high. Patients with a low GCS score, high NLR, low PLR, and hyperglycemia at admission are at greater risk of coagulopathy and poor prognosis. The efficacy of TXA in open TBI patients with coagulopathy is unclear. PLR may be a novel indicator for predicting coagulopathy.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Rohan Mathur, Jose I. Suarez
Summary: Traumatic Brain Injury (TBI) is associated with altered hemostasis and coagulopathy. Isolated Traumatic Brain Injury (iTBI) is also associated with systemic coagulopathy and derangements in hemostasis.
NEUROCRITICAL CARE
(2023)
Review
Clinical Neurology
Marc Maegele
Summary: TBI can lead to hemorrhagic progression and coagulopathy, affecting morbidity and mortality, with potential associations with preinjury use of antithrombotic agents and changes in coagulation function. Further research suggests the presence of both hyper- and hypocoagulable states after TBI, requiring more comprehensive hemostatic analysis.
Article
Critical Care Medicine
Kelly A. Fair, David H. Farrell, Belinda H. McCully, Elizabeth A. Rick, Elizabeth N. Dewey, Cole Hilliard, Rondi Dean, Amber Lin, Holly Hinson, Ronald Barbosa, Martin A. Schreiber, Susan E. Rowell
Summary: Traumatic intracranial hemorrhage is a significant cause of secondary brain injury in patients with traumatic brain injury. The severity of injury and D-dimer levels significantly differ between patients with and without PICH.
JOURNAL OF NEUROTRAUMA
(2021)
Review
Critical Care Medicine
Alexander Fletcher-Sandersjoo, Eric Peter Thelin, Marc Maegele, Mikael Svensson, Bo-Michael Bellander
Summary: Patients with severe traumatic brain injury often develop hemostatic disturbances which progress from impaired clot formation to a prothrombotic state, involving coagulation cascade dysfunction, hyperfibrinolysis, platelet dysfunction, and eventual fibrinolysis shutdown. Early administration of antifibrinolytic agents may reduce mortality, but further research is needed to understand the time course of these disruptions and potential treatment options.
NEUROCRITICAL CARE
(2021)
Review
Cell Biology
Liang Liu, Quan-Jun Deng
Summary: This review discusses platelet-derived extracellular vesicles, the most abundant type of extracellular vesicles in the blood of traumatic brain injury patients, and their important role in coagulopathy and inflammation. The progress of research on platelet-derived extracellular vesicles in coagulopathy and inflammation and their potential as therapeutic targets for traumatic brain injury are also discussed.
NEURAL REGENERATION RESEARCH
(2022)
Article
Surgery
Emily Breeding, Margaret Trainor, Ishraq Kabir, Michael Martyak
Summary: A retrospective chart review found that thromboelastography (TEG) is not reliable in assessing NOAC-related coagulopathy in traumatic brain injury (TBI) patients. Caution should be exercised when interpreting TEG data to determine reversal strategies in TBI patients on NOACs.
JOURNAL OF SURGICAL RESEARCH
(2023)
Article
Immunology
Zhengtao Gu, Li Li, Qin Li, Hongping Tan, Zhimin Zou, Xueyong Chen, Zichen Zhang, Yijun Zhou, Danian Wei, Chengyong Liu, Qiaobing Huang, Marc Maegele, Daozhang Cai, Mingguang Huang
Summary: Studies have shown that Polydatin (PD) has a protective effect on severe traumatic brain injury-induced acute lung injury (sTBI-ALI), reducing lung damage, promoting vascular permeability recovery, alleviating oxidative stress response and inflammatory cytokine release, and attenuating damage by inhibiting S100B-mediated NETs formation.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2021)
Article
Hematology
Taylor N. Anderson, David H. Farrell, Susan E. Rowell
Summary: Posttraumatic coagulopathy is caused by disruption of the coagulation and fibrinolytic pathways due to tissue damage, hypotension, and inflammatory upregulation. Early hyperfibrinolysis in TBI patients can lead to uncontrolled bleeding and higher mortality. Fibrinolytic assays are not routinely performed, while viscoelastic tests offer rapid evaluation of coagulation function and tranexamic acid may improve clinical outcomes.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2021)
