Traumatic brain injury in patients with mechanical heart valves on lifelong anticoagulation: incidence…

Cohort studyFrontiers in cardiovascular medicine· 2026

Traumatic brain injury in patients with mechanical heart valves on lifelong anticoagulation: incidence, management, and outcomes of intracranial hemorrhage.

Jastina Feiereisen, Rasha E Boulos, Can Keskinaslan … Hector Rodriguez Cetina Biefer

NeurotraumaCohort studyPrognosisQ1IF 2.9

Intracranial hemorrhage after brain injury linked to lower good outcomes in mechanical valve patients

Traumatic brain injury in patients with mechanical heart valves on lifelong anticoagulation: incidence, management, and outcomes of intracranial hemorrhage.

Jastina Feiereisen … Hector Rodriguez Cetina Biefer

Frontiers in cardiovascular medicine · 2026

Background

With mechanical heart valves require lifelong anticoagulation, exposing them to a substantially elevated risk of hemorrhagic complications following traumatic injury.

Purpose

This study aimed to characterize the incidence and severity of traumatic brain injury and intracranial hemorrhage in this population, to evaluate the impact of hemorrhage on composite good outcome, and to compare outcomes between surgical and conservative management strategies.

Methods

We conducted a retrospective observational cohort study of patients with mechanical heart valves who sustained at least one traumatic event at the University Hospital Zurich during 2012 and 2023.

n = 60 patients

Results

hemorrhage patients recovered well less often than those without bleeding

TBI without ICH

90%

TBI with ICH

66.7%

More results

Among 60 patients with mechanical heart valves, 43 (71.7%) sustained at least one traumatic brain injury, yielding 50 traumatic brain injury events over the study period.

Intracranial hemorrhage was present in 30 of 50 TBIs (60%).

More results

Among hemorrhagic TBIs, good outcome was observed in 5 of 9 surgically managed cases (55.6%) and 15 of 21 conservatively managed cases (71.4%).

“

Conclusion · 1 of 2

Intracranial hemorrhage following traumatic brain injury is common in anticoagulated mechanical valve patients and is associated with a lower rate of composite good outcome compared to traumatic brain injury without hemorrhage (66.7% vs.

Conclusion · 2 of 2

90.0%). Among haemorrhagic traumatic brain injury events, composite good outcomes were numerically more frequent with conservative than with surgical management (71.4% vs.

Traumatic brain injury in patients with mechanical heart valves on lifelong anticoagulation: incidence, management, and outcomes of intracranial hemorrhage.

Traumatic brain injury in patients with mechanical heart valves on lifelong anticoagulation: incidence, management, and outcomes of intracranial hemorrhage.

Related papers