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Does Head Injury In A Patient Taking Warfarin Causes Internal Bleeding? What Are The Signs Of The Internal Bleeding Due To Head Injury?

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Posted on Tue, 18 Apr 2023
Question: My mother is 90 and she fell today...she seems fine according to her caregiver and checked out ok with emt's. However, not sure they knew she is on Warfarin. I wasn't concerned until she said she hit her head..not sure how hard. Should I be concerned about internal bleeding? Are there any signs I should look for? Prefer not to have her taken to the hospital unless necessary. Thanks in advance-Tria
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Would NOT giving her her Wafarin tonight be a terrible idea?
I know it can mess up her blood levels, but not terribly for one pm and would that help if there was any minor bleeding?

doctor
Answered by Dr. Panagiotis Zografakis (7 minutes later)
Brief Answer:

There are some signs.

Detailed Answer:

Hello!

Head injuries in patients taking Warfarin can result in life-threatening bleeding inside the skull. Even minor injuries may cause bleeding.

The warning signs may include:
- Drowsiness, the patient may feel sleepy all the time,
- Coma, the patient remains unresponsive and cannot be awakened,
- Headache, a new headache after the injury may be a sign of bleeding,
- Nausea and vomiting,
- Increased systolic blood pressure due to the increased intracranial pressure,
- Bradycardia, slow heart rate due to the tumor effect of the blood collection,
- Various neurological signs which may resemble a stroke (like weakness, sensory deficits, etc)

In cases where a head injury occurs to patients under anticoagulant treatment, a CT-scan of the brain is an appropriate modality to exclude bleeding.

If you'd like to be sure then only the CT-scan may provide reliable evidence against bleeding. If she develops any of the aforementioned signs then going to the hospital ASAP would be your only option.

I hope you find my comments helpful. Let me know if I can assist you further.

Kind Regards,

Dr. Panagiotis Zografakis
Internal Medicine Specialist
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Brief Answer:
It's difficult to say...

Detailed Answer:

Hello!

Whether it's a terrible idea or not can be judged only by the outcome. I can say that taking Warfarin after an injury that caused bleeding may be fatal. I can't confirm that this is the right mode of action though. The best thing to do would be a CT-scan of the brain.

If she was one of my patients and I knew that she had no other option, I might have instructed her to skip the Warfarin until everything seemed fine. I would have been very puzzled if she took Warfarin because of a metallic heart valve though.

I hope it helps.

Kind Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (35 minutes later)
OK Got it and thank you!
doctor
Answered by Dr. Panagiotis Zografakis (9 minutes later)
Brief Answer:
You're welcome.

Detailed Answer:

You're welcome, glad to help!

Regards,
Dr. Panagiotis Zografakis
Internal Medicine Specialist
Note: Get a consultation booked to know more about aging related medical issues. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3816 Questions

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Does Head Injury In A Patient Taking Warfarin Causes Internal Bleeding? What Are The Signs Of The Internal Bleeding Due To Head Injury?

Brief Answer: There are some signs. Detailed Answer: Hello! Head injuries in patients taking Warfarin can result in life-threatening bleeding inside the skull. Even minor injuries may cause bleeding. The warning signs may include: - Drowsiness, the patient may feel sleepy all the time, - Coma, the patient remains unresponsive and cannot be awakened, - Headache, a new headache after the injury may be a sign of bleeding, - Nausea and vomiting, - Increased systolic blood pressure due to the increased intracranial pressure, - Bradycardia, slow heart rate due to the tumor effect of the blood collection, - Various neurological signs which may resemble a stroke (like weakness, sensory deficits, etc) In cases where a head injury occurs to patients under anticoagulant treatment, a CT-scan of the brain is an appropriate modality to exclude bleeding. If you'd like to be sure then only the CT-scan may provide reliable evidence against bleeding. If she develops any of the aforementioned signs then going to the hospital ASAP would be your only option. I hope you find my comments helpful. Let me know if I can assist you further. Kind Regards, Dr. Panagiotis Zografakis Internal Medicine Specialist ................................................................. Brief Answer: It's difficult to say... Detailed Answer: Hello! Whether it's a terrible idea or not can be judged only by the outcome. I can say that taking Warfarin after an injury that caused bleeding may be fatal. I can't confirm that this is the right mode of action though. The best thing to do would be a CT-scan of the brain. If she was one of my patients and I knew that she had no other option, I might have instructed her to skip the Warfarin until everything seemed fine. I would have been very puzzled if she took Warfarin because of a metallic heart valve though. I hope it helps. Kind Regards, Dr. Panagiotis Zografakis Internal Medicine Specialist