Vitamin K, fresh frozen plasma, and platelet transfusion used to arrest progression of intracranial hemorrhage after traumatic brain injury in a patient taking anticoagulant and antiplatelet agents

• Main Authors: Joe Yoshizawa, Jun Namiki, Yusho Nishida, Yasushi Kaneko, Shingo Hori
• Format: Article
• Language: English
• Published: Wiley 2016-10-01
• Series: Acute Medicine & Surgery
• Subjects: Anticoagulant; fresh frozen plasma transfusion; platelet transfusion; traumatic brain injury; vitamin K
• Online Access: https://doi.org/10.1002/ams2.200

Case An 89‐year‐old man fell from stairs and sustained head trauma. He was taking warfarin and aspirin. Upon arrival at our hospital, his Glasgow Coma Scale score was 14. Initial head computed tomography showed small acute subdural hematoma. We immediately administered vitamin K and ordered fresh‐frozen plasma. Repeat computed tomography 3 and 6 h after trauma revealed the acute subdural hematoma had increased to 14 and 20 mm, respectively, and there were several new intracranial hemorrhages. Fresh‐frozen plasma and platelet transfusion were initiated. Outcome Follow‐up computed tomography revealed no further progression of intracranial hemorrhages, and the patient's consciousness did not deteriorate further. Conclusion Appropriate administration of vitamin K, fresh‐frozen plasma, and platelets successfully arrested progression of traumatic intracranial hemorrhages in this patient taking anticoagulant/antiplatelet agents and may have averted brain surgery.