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

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.