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Emergency care
Tranexamic acid in acute traumatic brain injury
  1. Tanya Baron,
  2. Alex Novak
  1. Emergency Department, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Alex Novak, Emergency Department, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; alex.novak{at}

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The incidence of traumatic brain injury (TBI) is rising, with over 60 million people affected annually across the globe. 1 Tranexamic acid (TXA) is an inhibitor of fibrinolysis, which is readily available, easily administered, can be given in the prehospital phase and has been shown to have a good safety profile in trauma.2 Following the CRASH-2 trial, which showed a significant reduction in deaths from major extracranial bleeding in patients who had TXA administered within 3 hours of injury, CRASH-3 (Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial) was established as a large international multi-centred randomised placebo-controlled trial which investigated the effect of TXA in patients with an isolated TBI. 3

Patients were randomised to either TXA (1 g …

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  • Contributors Both TB and AN are free from conflicts of interest and played an equal part in the authorship of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.