Dose-dependent neuroprotective effect of enoxaparin on cold-induced traumatic brain injury

Keskin, İlknur; Günal, Mehmet Yalçın; Aytürk, Nilüfer; Kılıç, Ülkan; Ozansoy, Mehmet; Kılıç, Ertuğrul

doi:10.4103/1673-5374.206646

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…Moreover, in experimental mouse models of ischemic stroke, enoxaparin seems to offer good neuroprotection and reduce ischemic lesion size by 49%. 34 Similarly, Yi et al 35 showed that LMWH improved outcome in a dose-dependent manner after stroke, as clinically confirmed at 6 months, and was more effective than aspirin alone in preventing early neurologic deterioration and improving the 6-month outcome in patients with ischemic stroke. However, Paula Muñoz-Venturelli et al 23 showed that patients who received subcutaneous heparin had greater major disability at 90 days.…”

Section: Discussionmentioning

confidence: 94%

Safety of Prophylactic Heparin in the Prevention of Venous Thromboembolism After Spontaneous Intracerebral Hemorrhage: A Meta-analysis

Pan

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Objectives Patients with spontaneous intracerebral hemorrhage (sICH) have a nearly fourfold greater risk for venous thromboembolism (VTE) than those with acute ischemic stroke, and VTE after sICH is associated with high risk for in-hospital mortality. The benefit from prophylactic heparin for VTE remains uncertain because its safety is not documented. In this study, we used an updated meta-analysis to evaluate the safety of heparin for the prevention of VTE in patients with sICH. Methods Electronic databases Medline and Embase from January 1990 to November 2017 and the Cochrane Library were searched using these keywords: intracerebral hemorrhage, stroke, hemorrhagic stroke, subarachnoid hemorrhage, heparin, heparinoids, low-molecular-weight heparin, anticoagulants, prophylactic, low dose, prevention, deep venous thrombosis, pulmonary embolism, venous thrombosis, randomized controlled trial, controlled clinical trial, and outcome. We evaluated the quality of included studies according to the bias risk in the Cochrane Handbook for Systematic Reviews of Interventions v.5.1.0. All statistical analyses were performed with RevMan v.5 software (Cochrane Collaboration, London, United Kingdom). Tests of heterogeneity were conducted with the Mantel-Haenszel method. Results Nine studies involving 4,055 patients with sICH met the inclusion criteria in this meta-analysis. Of these studies, only one met all specific criteria and had a low probability of bias, whereas eight studies met only some of the criteria and had a moderate probability of bias. In comparison with non-heparin treatments, low-molecular-weight heparin or unfractionated heparin was associated with a nonsignificant increase in any hematoma enlargement, a nonsignificant reduction in extracranial hemorrhage, a nonsignificant increase in mortality, a nonsignificant increase in the number of modified Rankin Scale scores of 3 to 5, and a nonsignificant increase in numbers of Glasgow Outcome Scale scores of 2 to 3. Conclusion Prophylactic heparin was associated with a nonsignificant increase in any hematoma enlargement and mortality, a nonsignificant reduction in extracranial hemorrhage, and a nonsignificant increase in the incidence of major disability in patients with sICH. It is probably safe to administer heparin to prevent VTE in patients with sICH.

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Section: Discussionmentioning

confidence: 94%

Safety of Prophylactic Heparin in the Prevention of Venous Thromboembolism After Spontaneous Intracerebral Hemorrhage: A Meta-analysis

Pan

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…Growing evidence suggests enoxaparin sodium has the ability to accelerate neurologic recovery and greatly reduce cell apoptosis, inflammation, and edema in animals with induced TBI. 6,15…”

Section: Discussionmentioning

confidence: 99%

Progression of Intracranial Hemorrhage After Chemical Prophylaxis Using Low-Molecular-Weight Heparin in Patients With Traumatic Brain Injury

Thier

Drake-Lavelle

Prest

et al. 2021

The American Surgeon™

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Introduction Chemical prophylaxis using low-molecular-weight heparin (LMWH) is considered a standard of care for venous thromboembolism in trauma patients. Our center performs a head computed tomography (CT) scan 24 hours after initiation with prophylactic LMWH in the setting of a known traumatic brain injury (TBI). The purpose was to determine the overall incidence of ICH progression after chemoprophylaxis in patients with a TBI. Methods This retrospective study was performed at a Level I trauma center, from 1/1/2014 to 12/31/2017. Study patients were drawn from the institution’s trauma registry based on Abbreviated Injury Score codes. Results 778 patients met all inclusion criteria after initial chart review. The proportion of patients with an observed radiographic progression of intracranial hemorrhage after LMWH was 5.8%. 3.1% of patients had a change in clinical management. Observed radiographic progression after LMWH prophylaxis and the presence of SDH on initial CT, the bilateral absence of pupillary response in the emergency department, and a diagnosis of dementia were found to have statistically significant correlation with bleed progression after LMWH was initiated. Conclusion Over a 4-year period, the use of CT to evaluate for radiographic progression of traumatic intracranial hemorrhage 24 hours after receiving LMWH resulted in a change in clinical management for 3.1% of patients. The odds of intracranial hemorrhage progression were approximately 6.5× greater in patients with subdural hemorrhage on initial CT, 3.1× greater in patients with lack of bilateral pupillary response in ED, and 4.2× greater in patients who had been diagnosed with dementia.

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“…The brain injury was performed as previously described for a cryogenic trauma model (21,22).All the mice were anaesthetized with intraperitoneally (i.p.) ketamine (60 mg/ kg) and xylazine (6 mg/ kg) and fixed in the stereotaxic device.…”

Section: Cold Injurymentioning

confidence: 99%

The neuroprotective effect of Coconut Oil in mice with Traumatic Brain Injury

Çankaya¹,

Günal²,

Beker

et al. 2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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This study aimed to evaluate the possible neuroprotective effect of coconut oil in mice with traumatic brain injury.Material and Methods:Ten adult male mice (C57BL/6) were randomly assigned into the control (n=5) and coconut oil administered group (n=5). The control group was received 250 μl saline/day and coconut oil was administered 10 mg/kg/day per os to the coconut oil group for a week. Brain coold injury model was produced on seventh day. 24 hours after the injury, infarction and oedema volume in the brain was measured in two groups. Results:The coconut oil group mice were found to exhibit lower brain infarct volume and edema than the control group mice. Conclusion:Our findings indicated that coconut oil has a potential neuroprotective effect on damaged neurons after traumatic brain injury in mice.

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Dose-dependent neuroprotective effect of enoxaparin on cold-induced traumatic brain injury

Cited by 14 publications

References 21 publications

Safety of Prophylactic Heparin in the Prevention of Venous Thromboembolism After Spontaneous Intracerebral Hemorrhage: A Meta-analysis

Safety of Prophylactic Heparin in the Prevention of Venous Thromboembolism After Spontaneous Intracerebral Hemorrhage: A Meta-analysis

Progression of Intracranial Hemorrhage After Chemical Prophylaxis Using Low-Molecular-Weight Heparin in Patients With Traumatic Brain Injury

The neuroprotective effect of Coconut Oil in mice with Traumatic Brain Injury

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