Intracranial lesion yield and downstream management after mild traumatic brain injury in emergency department patients receiving antiplatelet therapy: a two-center retrospective cohort study.
5 affiliations
- 1Emergency Department, Orléans University, Orléans University Hospital, 14 Avenue de l'hôpital, Orléans, 45100, France.
- 2Sports Medicine Department, Orléans University, Orléans University Hospital, Orléans, 45100, France.
- 3LI²RSO, Orléans University, Orléans University Hospital, Orléans, 45100, France.
- 4Emergency Department, Orléans University, Orléans University Hospital, 14 Avenue de l'hôpital, Orléans, 45100, France. [email protected].
- 5LI²RSO, Orléans University, Orléans University Hospital, Orléans, 45100, France. [email protected].
Abstract
Background
Mild traumatic brain injury (mTBI) in patients receiving antiplatelet therapy is a frequent emergency department presentation. We aimed to describe the prevalence of traumatic intracranial lesions on the initial head computed tomography (CT) scan and the downstream in-hospital management of antiplatelet-treated adults with mTBI.Methods
We conducted a retrospective two-center cohort study in the emergency departments of Tours and Orléans University Hospitals, France. Adults receiving antiplatelet therapy who presented with mTBI (Glasgow Coma Scale score 13-15) and underwent an initial head CT scan were included. The primary outcome was the presence of any traumatic intracranial lesion on the initial CT scan. Secondary outcomes included downstream management during the index episode. An exploratory multivariable logistic regression analysis was performed using pre-CT variables.Results
A total of 1,912 patients were included; mean age was 80.8 ± 12.1 years and 52.1% were women. Traumatic intracranial lesions were identified in 282 patients (14.7%). Among patients with lesions, 232 (82.3%) underwent hospital admission or 24-hour emergency department observation, 16 (5.7%) required neurosurgical management, and 104 (36.9%) underwent repeat brain imaging. In exploratory multivariable analysis, falls above standing height or high-energy falls (adjusted odds ratio [aOR] 2.84, 95% confidence interval [CI] 1.95-4.14), other trauma mechanisms (aOR 1.82, 95% CI 1.30-2.54), motor deficit at presentation (aOR 3.71, 95% CI 1.95-6.81), facial fracture (aOR 2.25, 95% CI 1.51-3.31), and temporal impact (aOR 1.94, 95% CI 1.29-2.85) were independently associated with traumatic intracranial lesions.Conclusions
In antiplatelet-treated adults with mTBI, traumatic intracranial lesions were detected in approximately one in seven patients on the initial CT scan, whereas neurosurgical intervention remained uncommon. Trauma-related clinical features appeared more informative than age alone for lesion detection.
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BibTeX
@article{padova2026intracranial,
title = {{Intracranial lesion yield and downstream management after mild traumatic brain injury in emergency department patients receiving antiplatelet therapy: a two-center retrospective cohort study.}},
author = {Fatima Di Padova and Tifany Sekulski and Dounia Hamdouche and Romain Jouffroy and Vincent Garrouste},
journal = {BMC emergency medicine},
year = {2026},
month = jul,
doi = {10.1186/s12873-026-01684-8},
url = {https://europepmc.org/article/MED/42902166},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intracranial lesion yield and downstream management after mild traumatic brain injury in emergency department patients receiving antiplatelet therapy: a two-center retrospective cohort study.
AU - Fatima Di Padova
AU - Tifany Sekulski
AU - Dounia Hamdouche
AU - Romain Jouffroy
AU - Vincent Garrouste
PY - 2026
DA - 2026/07/01
JO - BMC emergency medicine
DO - 10.1186/s12873-026-01684-8
UR - https://europepmc.org/article/MED/42902166
AB - Background Mild traumatic brain injury (mTBI) in patients receiving antiplatelet therapy is a frequent emergency department presentation. We aimed to describe the prevalence of traumatic intracranial lesions on the initial head computed tomography (CT) scan and the downstream in-hospital management of antiplatelet-treated adults with mTBI.Methods We conducted a retrospective two-center cohort study in the emergency departments of Tours and Orléans University Hospitals, France. Adults receiving antiplatelet therapy who presented with mTBI (Glasgow Coma Scale score 13-15) and underwent an initial head CT scan were included. The primary outcome was the presence of any traumatic intracranial lesion on the initial CT scan. Secondary outcomes included downstream management during the index episode. An exploratory multivariable logistic regression analysis was performed using pre-CT variables.Results A total of 1,912 patients were included; mean age was 80.8 ± 12.1 years and 52.1% were women. Traumatic intracranial lesions were identified in 282 patients (14.7%). Among patients with lesions, 232 (82.3%) underwent hospital admission or 24-hour emergency department observation, 16 (5.7%) required neurosurgical management, and 104 (36.9%) underwent repeat brain imaging. In exploratory multivariable analysis, falls above standing height or high-energy falls (adjusted odds ratio [aOR] 2.84, 95% confidence interval [CI] 1.95-4.14), other trauma mechanisms (aOR 1.82, 95% CI 1.30-2.54), motor deficit at presentation (aOR 3.71, 95% CI 1.95-6.81), facial fracture (aOR 2.25, 95% CI 1.51-3.31), and temporal impact (aOR 1.94, 95% CI 1.29-2.85) were independently associated with traumatic intracranial lesions.Conclusions In antiplatelet-treated adults with mTBI, traumatic intracranial lesions were detected in approximately one in seven patients on the initial CT scan, whereas neurosurgical intervention remained uncommon. Trauma-related clinical features appeared more informative than age alone for lesion detection.
SN - 1471-227X
ER -