Risk Of Delayed Intracranial Hemorrhage in Anticoagulated Patients With Mild Traumatic Brain Injury

Systematic Review and Meta-Analysis

Jean-Marc Chauny, MD, MSC; Martin Marquis, MSC; Francis Bernard, MD; David Williamson, BPHARM, PHD; Martin Albert, MD; Mathieu Laroche, MD, MSC; Raoul Daoust, MD, MSC


J Emerg Med. 2016;51(5):519-528. 

In This Article


The aim of this meta-analysis was to assess the risk of delayed intracerebral bleeding in patients suffering a mild traumatic brain injury who have been anticoagulated with vitamin K antagonist before injury. We found that the incidence of delayed bleeding in patients with an initially normal head scan was very low at 0.6%. Furthermore, 85% of the patients with delayed hemorrhage did not require clinical intervention, reducing even further the risk of significant outcomes to 0.13%. This risk is sufficiently low to justify discharging the patients after the initial evaluation by a physician when the first scan is negative.