Management of Traumatic Brain Injury in the Face of Antithrombotic Medication Therapy

Traumatic brain injury (TBI) is associated with both hypercoagulable and hypocoagulable states; however, the causes of each are still not well understood. These coagulopathies are further complicated by TBI patients who are injured while on antithrombotic medications. This chapter compiles data from the most recent peer-reviewed publications and drug references on the pathophysiology of coagulopathy in TBI patients, predictors of outcomes, the impact of preinjury antithrombotic medication use, reversal agents, monitoring parameters, and when to restart antithrombotic medications post-TBI. Direct-acting oral anticoagulants (DOACs) and their impact on TBI management are discussed in detail.