Tranexamic acid in traumatic brain injury

@# General Hospital. In all 167 of them wereadministered with TXA and another 167 of the patients werenot. The primary outcome expected is the number of goodoutcomes in isolated TBI patients given TXA. Goodoutcome is defined by Glasgow Outcome Score-Extended(GOSE) of five and above. Secondary outcome was clotexpansion of an intracranial bleed seen on the first scan thathad expanded by 25% or more on any dimension on thesecond scan. Results: The TXA did not show significant trend of goodoutcome in terms of GOSE (p=0.763). However, for moderateand severe acute subdural haemorrhage (SDH) subgroups,there was a significant difference (p=0.042). Clot expansionwas present in 14 patients (12.7%) with TXA given and in 54patients (38.8%) without TXA. The difference wasstatistically significant (p<0.001). Of the patients whoreceived TXA, there was one case (0.6%) of deep veinthrombosis. Apart from that, TXA showed non-significanttrend in reducing mortality (p=0.474). Conclusions: Tranexamic acid reduces the rate of clotexpansion in TBI by 26.1% (38.8-12.7%) without significantlyincreasing the risk of a thrombotic event. It can also improvethe outcome of moderate and severe TBI patients with acuteSDH.

Brain and Spinal Tumour

This study reviewed the epidemiology of brain and spinal tumours in Sarawak from January 2009 till December 2012. The crude incidence of brain tumour in Sarawak was 4.6 per 100,000 population/year with cumulative rate 0.5%. Meningioma was the most common brain tumour (32.3%) and followed by astrocytoma (19.4%). Only brain metastases showed a rising trend and cases were doubled in 4 years. This accounted for 15.4% and lung carcinoma was the commonest primary. Others tumour load were consistent. Primitive neuroectodermal tumour (PNET) and astrocytoma were common in paediatrics (60%). We encountered more primary spinal tumour rather than spinal metastases. Intradural schwannoma was the commonest and frequently located at thoracic level. The current healthcare system in Sarawak enables a more consolidate data collection to reflect accurate brain tumours incidence. This advantage allows subsequent future survival outcome research and benchmarking for healthcare resource planning.