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17.06.2020 | Review

Tranexamic acid in Neurosurgery: a controversy indication—review

verfasst von: José Luiz de Faria, Josué da Silva Brito, Louise Teixeira Costa e Silva, Christiano Tadeu Sanches Mattos Kilesse, Nicolli Bellotti de Souza, Carlos Umberto Pereira, Eberval Gadelha Figueiredo, Nícollas Nunes Rabelo

Erschienen in: Neurosurgical Review | Ausgabe 3/2021

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Abstract

Tranexamic acid (TXA) is one of the measures indicated to reduce bleeding and the need for volume replacement. However, data on risks and benefits are controversial. This study analyzes the effectivity and risks of using tranexamic acid in neurosurgery. We selected articles, published from 1976 to 2019, on the PubMed, EMBASE, Science Direct, and The Cochrane Database using the descriptors: “tranexamic acid,” “neurosurgery,” “traumatic brain injury,” “subdural hemorrhage,” “brain aneurysm,” and “subarachnoid hemorrhage.” TXA can reduce blood loss and the need for blood transfusion in trauma and spinal surgery. Despite the benefits of TXA, moderate-to-high doses are potentially associated with neurological complications (seizures, transient ischemic attack, delirium) in adults and children. In a ruptured intracranial aneurysm, the use of TXA can considerably reduce the risk of rebleeding, but there is weak evidence regarding its influence on mortality reduction. The TXA use in brain surgery does not present benefit. However, this conclusion is limited because there are few studies. TXA in neurosurgeries is a promising method for the maintenance of hemostasis in affected patients, mainly in traumatic brain injury and spinal surgery; nevertheless, there is lack of evidence in brain and vascular surgeries. Many questions remain unanswered, such as how to determine the dosage that triggers the onset of associated complications, or how to adjust the dose for chronic kidney disease patients.

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Titel: Tranexamic acid in Neurosurgery: a controversy indication—review
verfasst von: José Luiz de Faria
Josué da Silva Brito
Louise Teixeira Costa e Silva
Christiano Tadeu Sanches Mattos Kilesse
Nicolli Bellotti de Souza
Carlos Umberto Pereira
Eberval Gadelha Figueiredo
Nícollas Nunes Rabelo
Publikationsdatum: 17.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Neurosurgical Review / Ausgabe 3/2021
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-020-01324-0

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Tranexamic acid in Neurosurgery: a controversy indication—review

Abstract

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