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 1).