Antithrombotic therapy not associated with increased traumatic ICH on CT in adults

Vardar and colleagues' retrospective case-control study included 1,630 patients (693 female, 937 male; mean age, 80 years) who underwent head CT after presenting to the emergency department (ED) with ground-level fall (Glasgow Coma Scale ≥ 14 and no focal neurological deficit) between January 1 and December 31, 2020. Initial head CT examinations were reviewed for traumatic intracranial hemorrhage characteristics and follow-up head CT examinations (performed within 24 hours) were reviewed for hematoma expansion, with clinical outcomes extracted from medical records.

The frequency of intracranial hemorrhage after ground-level fall with good neurological status was not significantly different between patients on antithrombotic therapy and those not on antithrombotic therapy (4.4% vs 3.1% respectively, p = .24). However, hematoma expansion occurred more frequently in patients on antithrombotic therapy (26.2% vs 4.8%, p = .04).

Also noting no significant difference between patients on anticoagulant therapy alone, antiplatelet therapy alone, or both, "the frequency of midline shift and regional mass effect was not significantly different between patients on antithrombotic therapy and control patients," the authors of this AJR article added.