Abdurrahman F. Kharbat^1§, Drashti Patel^2§, Kiran Sankarappan³, Raja Al-Bahou², Faisal Alamri⁴, Anjali Patel², Rajvi Thakkar², Ryan

1. Morgan5,Kishore Balasubramanian3, Brandon Lucke-Wold*6 

¹Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

²College of Medicine, University of Florida, Gainesville, FL, USA. ³College of Medicine, Texas A and M University, Houston, TX, USA. ⁴King Salman Hospital, Riyadh, Kingdom of Saudi Arabia.

⁵Division of Neurosurgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

⁶University of Florida, Department of Neurosurgery, Gainesville, Florida, USA.

• A.K. and D.P. contributted equally to this paper.

Correspondence to: Brandon Lucke-Wold, University of Florida, Department of Neurosurgery, Gainesville, Florida, USA.

Received date: March 28, 2024; Accepted date: April 05, 2024; Published date: April 15, 2024

Citation: Kharbat AF, Patel D, Sankarappan K, et al. Timing of Agent Resumption and Therapeutic Targets in the Pathophysiology of Traumatic Brain Injuries,

IJMRS @ PubScholars Group 2024;1(3):10–19

Copyright: ©2024 Kharbat AF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract:

An estimated 69 million people worldwide suffer from traumatic brain injuries each year. Direct head trauma can cause traumatic brain hemorrhage, which can be life-threatening if not treated quickly. Current studies suggest the use of antithrombotic therapy for treatment, but the optimal duration of such therapy in neurosurgery remains controversial. This article critically reviews recommendations regarding the ideal timing of antiplatelet and anticoagulant therapy for diseases such as subarachnoid hemorrhage, subdural hematoma, skull fractures, brain contusions, and diffuse axonal injury. . Additionally, the role of these agents in the context of prosthetic valves and stents will be examined, and their effects on bleeding time and platelet aggregation will be evaluated. This review highlights possible directions for future research in this area and highlights the limitations inherent in the current literature. In the case of hemorrhage in TBI, the standard of care is to resume appropriate AAT at intervals to reduce the risk of ICH, but timing and treatment vary among clinicians. Various studies have shown that restarting AAT reduces the long-term risk of thrombotic events and ischemic stroke. However, this benefit should be weighed against the risk of her developing ICH if AAT is restarted too soon. Timing of resumption of AAT should be determined based on multidisciplinary risk stratification considering patient risk factors and comorbidities that may predispose to thromboembolic complications due to prolonged discontinuation of AAT cessation.