The Safety and Efficacy of Platelet Transfusion in Patients Receiving Antiplatelet Therapy that Sustain Intracranial Hemorrhage
Mark Cipolle, MD, PhD

Brain hemorrhage is the most important reason for death and disability after injury or stroke. Many of our patients are using antiplatelet medications that inhibit the early steps in blood clotting. While these medications are very effective in reducing the risk of heart attack and stroke, bleeding is an important side effect. While these medications do not cause brain hemorrhage, it is likely that they worsen a hemorrhage once it has occurred.

In the first year of the study, there will be a pilot trial of 40 patients to prepare for a multicenter, randomized, controlled clinical trial to test the potential benefit and safety of providing a platelet transfusion to patients suffering a brain hemorrhage while taking antiplatelet medication. Patients on antiplatelet therapy that have a brain hemorrhage seen on CT scan within four hours of injury or onset of symptoms will be eligible. They will then be randomized (coin flip) to receive either a platelet transfusion or an infusion of salt water (control). Another CT scan will be obtained in 24 hours and researchers will compare the change in hemorrhage between groups.

Other outcome measures to be tracked will be improvement in neurologic outcome and the development of a new heart attack, stroke or blood clot out to 90 days. The researchers will also examine platelet function in all patients using a bedside test. An institutional review board and data safety monitoring board will oversee the trial to ensure patient safety.