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Drugs for Blunt Cerebrovascular Injuries Compared

Systemic heparin and antiplatelet agents work equally well, study suggests

THURSDAY, July 23 (HealthDay News) -- Both systemic heparin and antiplatelet agents are effective in treating blunt cerebrovascular injuries, according to a paper published in the July issue of the Archives of Surgery.

C. Clay Cothren, M.D., and colleagues at the University of Colorado School of Medicine in Denver, conducted a study of 301 patients who between them had 422 blunt cerebrovascular injuries. There were five patients who had a cerebrovascular accident after embolization or stenting of an injury, and 22 patients presented with neurologic ischemia.

In all, 282 asymptomatic blunt cerebrovascular injuries were treated, 192 with heparin, 67 with aspirin and 23 with aspirin and/or clopidogrel, and one patient had a cerebrovascular accident, the researchers found. However, among the 107 untreated patients, 23 (21.5 percent) had a cerebrovascular accident. The injury healing and injury progression rates among the treated patients were very similar, regardless of the treatment regimen used.

"If untreated, carotid artery injuries have a stroke rate of up to 50 percent, and increasing stroke rates correlate with increasing grades of injury," the authors write. "The early diagnosis of blunt cerebrovascular injury allows prompt initiation of treatment, with apparent equal efficacy of anticoagulation and antiplatelet agents in preventing stroke. The choice of therapy should be individualized based on the patient's associated injuries and risk of bleeding."

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