Introduction: Controlling of secondary traumatic brain injuries (TBI) is necessary due to
its salient effect on the improvement of patients with TBI and the final outcomes within early hours
of trauma onset. This study aims to investigate the effect of intravenous tranexamic acid (TAX) administration
on decreased hemorrhage during surgery.
Methods: This double-blind, randomized, and placebo-controlled trial was conducted on patients referring
to the emergency department (ED) with IPH due to brain contusion within 8 h of injury onset.
The patients were evaluated by receiving TXA and 0.9% normal saline as a placebo. The following
evaluation and estimations were performed: intracranial hemorrhage volume after surgery using brain
CT-scan; hemoglobin (Hb) volume before, immediately after, and six hours after surgery; and the severity
of TBI based on Glasgow Coma Score (GCS).
Results: 40 patients with 55.02 ± 18.64 years old diagnosed with a contusion and intraparenchymal
hemorrhage. Although the (Mean ± SD) hemorrhage during surgery in patients receiving TXA
(784.21 ± 304.162) was lower than the placebo group (805.26 ± 300.876), no significant difference
was observed between two groups (P=0.83). The (Mean ± SD) Hb volume reduction immediately
during surgery (0.07 ± 0.001 and 0.23 ± 0.02) and six hours after surgery (0.04 ± 0.008 and 0.12 ±
0.006) was also lower in TXA group but had no significant difference (P = 0.89 and P = 0.97, respectively).
Conclusion: Using TXA may reduce the hemorrhage in patients with TBI, but this effect, as in this
study, was not statistically significant and it is suggested that a clinical trial with a larger population
is employed for further investigation.