A three-year study of more than 1,000 patients found that the risk of delayed intracranial hemorrhage and death following head trauma was significantly higher for adults taking older blood thinning medications including clopidogrel (Plavix) and warfarin (Coumadin), according to research being presented today at the annual meeting of the Radiological Society of North America (RSNA).

The effects of newer blood thinners such as Pradaxa and Xarelto were not included in the report.

Taking aspirin concurrently with any blood thinner may increase the risk of delayed hemorrhage.

Intracranial hemorrhage occurs when blood vessels within the brain rupture, releasing blood into the brain tissue. In a delayed traumatic intracranial hemorrhage, bleeding in the brain occurs after the initial trauma, usually within 48 hours, after an initial negative head CT.

High blood pressure, head injury and the use of blood thinners are known causes of intracranial hemorrhage. As the population ages, the prevalence of patients taking blood thinners is increasing.

“The incidence of delayed posttraumatic intracranial hemorrhage in patients on different types of blood thinners with and without the addition of aspirin is not well established,” said Warren Chang, M.D., neuroradiologist and director of research at the Imaging Institute of the Allegheny Health Network in Pennsylvania. “This is an active area of investigation, especially as novel blood thinners become more widely adopted.”

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