====== Tranexamic acid for traumatic intracerebral hemorrhage ======

Controlling of secondary brain injury is necessary due to its salient effect on the improvement of patients with [[TBI]] and the final outcomes within early hours of trauma onset. 

A double-blind, randomized and placebo-controlled trial was conducted on patients referring to the [[emergency department]] (ED) with [[traumatic intracerebral hemorrhage]] within 8 h of injury onset. The patients were evaluated by receiving [[tranexamic acid]] (TXA) and 0.9% [[normal saline]] as a [[placebo]]. The following evaluation and estimations were performed: [[intracranial hemorrhage volume]] after surgery using brain CT-scan; hemoglobin (Hb) volume before, immediately after, and six hours after surgery; and the severity of TBI based on Glasgow Coma Score (GCC).

40 patients with 55.02 ± 18.64 years old diagnosed with a contusion and intraparenchymal hemorrhage. Although the (Mean ± SD) hemorrhage during surgery in patients receiving TXA (784.21 ± 304.162) was lower than placebo group (805.26 ± 300.876), no significant difference was observed between two groups (P=0.83). The (Mean ± SD) Hb volume reduction immediately during surgery (0.07±0.001 and 0.23±0.02) and six hours after surgery (0.04±0.008 and 0.12±0.006) was also lower in TXA group but had no significant difference (P = 0.89 and P = 0.97 respectively).

Using TXA may reduce the hemorrhage in patients with TBI, but this effect, as in this study, was not statistically significant and it is suggested that a clinical trial with a larger population is employed for further investigation
((Mousavinejad M, Mozafari J, Ilkhchi RB, Hanafi MG, Ebrahimi P. Intravenous
Tranexamic Acid for Brain Contusion with Intraparenchymal Hemorrhage: Randomized,
Double-blind, Placebo-controlled Trial. Rev Recent Clin Trials. 2019 Nov 17. doi:
10.2174/1574887114666191118111826. [Epub ahead of print] PubMed PMID: 31744452.
)).