Mild head injury, anticoagulants, and risk of intracranial injury

Lancet. 2001 Mar 10;357(9258):771-2. doi: 10.1016/S0140-6736(00)04163-5.


We studied intracranial damage in patients with mild head injuries who were taking warfarin. Of the 215,785 individuals who visited the Mount Auburn and Beth Israel accident and emergency departments during our study, we identified records for 144 patients by anticoagulation status and computed tomography (CT) imaging. We retrospectively reviewed these patients and ten (7%, 95% CI 3-11) with clinically important injuries on cranial CT. Our findings suggest that patients with head injuries who receive anticoagulants have a similar or greater risk of intracranlal injury to those falling into a previously defined moderate-risk category, invalidating a previous conclusion that CT scanning is unnecessary in such patients.

Publication types

  • Letter

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / diagnostic imaging
  • Female
  • Humans
  • Intracranial Hemorrhages / chemically induced
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / etiology*
  • Male
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed
  • Warfarin / adverse effects*
  • Warfarin / therapeutic use


  • Anticoagulants
  • Warfarin