Coagulofibrinolytic changes after isolated head injury are not different from those in trauma patients without head injury

Background: To test the hypothesis that tissue factor release, thrombin act ivation, fibrin formation, and fibrinolysis after an isolated head injury a re equal to those in patients without head injury, as well as to investigat e the precise time course of the coagulation and fibrinolytic abnormalities after head injury, we performed prospective and retrospective studies, Methods and Results: In the prospective study, 5 patients with isolated hea d injury and 11 trauma patients without head injury took part in this study , Tissue factor antigen concentration, prothrombin fragment F1+2, thrombin antithrombin complex, fibrinopeptide A, and fibrin degradation products (D- dimer) were measured on the day of admission, and days 1, 2, 3, and 4 after admission. The levels of all fire hemostatic molecular markers were marked ly elevated on the day of admission, and then gradually decreased to day 4. The levels and the time course of these hemostatic markers in patients wit h isolated head injury were not different from those in the control patient s. The same incidence of disseminated intravascular coagulation between the two groups H-as also observed, In the retrospective study, the records of fibrinopeptide Bbeta 15-42, plasmin antiplasmin complex, plasminogen activa tor inhibitor-1 antigen concentration (PAI-1 antigen), and PAI-1 activity i n 76 trauma patients were reviewed. On the basis of the exclusion criteria, 9 patients with isolated head injury and 30 control patients were selected for the study group, Fibrinopeptide Bbeta 15-42 and plasmin antiplasmin co mplex markedly elevated on the day of admission, then decreased on dq 1, an d tended to increase to day 5, markedly elevated PAI-1 antigen and PAI-1 ac tivity on the day of admission significantly decreased on day 1 and recover ed to the normal values on day,5, The changes of these molecular markers in patients with isolated head injury,were equal to those in the control pati ents. Conclusion: We systematically elucidated the time course of coagulation and fibrinolysis after isolated head injury. We further demonstrated that chan ges in coagulofibrinolytic and antifibrinolytic systems in patients with is olated head injury are not different from those in patients without head in jury.