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Transarterial embolisation for intractable post-traumatic oronasal haemorrhage following traumatic brain injury: evaluation of prognostic factors.

Liao CC, Tseng YY, Chen CT

Departments of Neurosurgery and Plastic Surgery, Chang Gung University and Chang Gung Memorial Hospital, 5 Fuxing 1st Road, Guishan, Taoyuan 333, Taiwan, ROC. liao2901@adm.cgmh.org.tw

AIM: To analyse the outcomes of transarterial embolisation (TAE) for post-traumatic oronasal haemorrhage following traumatic brain injury (TBI), for clinical application and prognosis. METHOD: Retrospective review of records of 17 patients treated in the neurosurgical intensive care unit for TBI complicated with intractable post-traumatic oronasal haemorrhage requiring TAE. The Mann-Whitney U-test, Wilcoxon signed rank test and Fisher's exact test were used in statistical analysis. RESULTS: TAE successfully stopped the post-traumatic oronasal haemorrhage in 13 of 17 cases. The internal maxillary artery was the most common haemorrhaging vessel requiring embolisation. Successful haemostasis contributed significantly to survival. CONCLUSION: Transarterial embolisation may stop intractable post-traumatic oronasal haemorrhage when conventional packing fails. Shock index (calculated as heart rate/systolic blood pressure) before and after TAE <1.2 and <0.8, respectively, and higher Glasgow Coma Scale (>8) before than after TAE, were positively correlated with survival.

Published 4 April 2008 in Injury, 39(5): 507-11.
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