Coagulation-fibrinolysis Activity is not Accelerated in Patients with Diffuse Axonal Injury

Abstract

Background: The plasma level of D-dimer (DD) on admission is useful as a prognostic marker of head injury. Methods: Eighty patients with isolated blunt head trauma were grouped according to the type of brain parenchymal injury using MRI. The differences in the DD levels among the groups, and the correlation between the DD levels and the patients' outcome, were investigated. Results: All patients were categorized into the following groups: diffuse axonal injury (DAI, n=24), cerebral contusion (CON, n=47), and no intraparenchymal lesion (NIL, n=9). The DD level was significantly higher in the CON-group than in the other two groups. In the CON-group, the patients with an unfavorable outcome had significantly higher DD levels. In the DAI-group, however, the DD level remained generally low regardless of the outcome. Conclusions: The DD level was sensitive to the type of brain injury. In the DAI-group, however, the coagulation-fibrinolysis activity was not accelerated to as great an extent as it was in the CON-group, therefore even the DD level was not a good prognostic indicator.