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Potential Life Saving, Simple Injection For Patients With Traumatic Brain Injury

a doctor providing medical care for a patient in the hospitalNew research has suggested that tranexamic acid has the potential to prevent people dying from head injuries. The CRASH-2 Intracranial Bleeding Study highlights the potential of the cheap, off-patent drug to help people suffering from brain trauma, also known as traumatic brain injury (TBI). The results are now published online in the BMJ.

According to the collaborators – led by the London School of Hygiene & Tropical Medicine – the results provide strong grounds to test the effect of this treatment in a larger and definitive study. The forthcoming CRASH-3 trial will determine reliably the effectiveness of tranexamic acid in patients with head injury. Additional information about this trial, including how to participant, can be found here.

Every year millions of people world-wide are treated for head injury. Unfortunately, currently there is no proven effective treatment for this life threatening condition, which affects mainly young working people. One of the frequent complications occurring after head injury is bleeding into the head. Usually this bleeding progresses in the first hours after the injury and produces more brain damage. Because tranexamic acid reduces clot breakdown, the investigators hypothesized that this drug could reduce bleeding into the brain and therefore improve patients’ outcomes.

The CRASH-2 Intracranial Bleeding Study was the first to evaluate the effect of tranexamic acid on head injury patients. The results showed that patients who receive tranexamic acid were less likely to have bleeding progression, they survive more, and with less disability.

The study involved 270 adult trauma patients with, or at risk of, significant extracranial bleeding within 8 hours of injury, who also had traumatic brain injury. It was a prospective randomized controlled trial carried out within the larger CRASH-2 trial to quantify the effect of an early short course of tranexamic acid on intracranial haemorrhage.

Dr. Pablo Perel, who is based in the Clinical Trials Unit at LSHTM, says: “Although the results are not definitive they provide hope about the potential effectiveness of this simple drug for head injury patients. If such an inexpensive and widely practicable treatment were found to improve patient outcomes after head injury this would have major implications for clinical care.”

Material adapted from London School of Hygiene & Tropical Medicine.

Effect of tranexamic acid in traumatic brain injury: a nested randomised, placebo controlled trial (CRASH-2 Intracranial Bleeding Study). BMJ 2011;342:d3795 doi: 10.1136/bmj.d3795

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