The use of anticoagulants in patients at risk of delayed parenchymal hemorrhagic lesions in the acute period of severe traumatic brain injury

INTRODUCTION . The correct use of anticoagulants in patients with severe traumatic brain injury is a difficult task for a practicing physician. On the one hand, their irrational use may play a negative role in the development of late intracranial hemorrhages in the acute period of traumatic brain injury. On the other hand, the risk of thrombotic complications in this group of patients is also high, so the need for correction of the hemostasis system is beyond doubt. AIM . To determine the timing of the start of taking anticoagulants in patients with a high risk of delayed parenchymal hemorrhagic brain damage in the acute period of traumatic brain injury. MATERIALS AND METHODS . The inpatient records of 81 patients with severe traumatic brain injury who were treated at the Clinical Emergency Hospital in Tver from 2016 to 2020 were studied. RESULTS . As a result of statistical processing of data from laboratory tests (coagulogram, platelet count in the general blood test), it was found that patients in the group with delayed parenchymal brain damage have a tendency to hypocoagulation and thrombocytopenia. The peak of hypocoagulation occurs on the 9–14th day. CONCLUSION . In patients with a high risk of delayed parenchymal hemorrhagic brain damage, it is advisable to prescribe anticoagulants on day 14, and if the patient has a high risk of thromboembolic complications, then anticoagulants are recommended to be prescribed as early as 4 days after the injury.