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According to this study, no TXA 2g bolus was not found to increase the number of seizures in TBI pts.
TXA has been shown to improve mortality in inter cranial hemorrhage trauma patients if given within 2 hours. TXA is also known to lower seizure threshold. This study was a secondary analysis of a larger study comparing placebo to 1 g TXA bolus plus 8 hour infusion or 2g bolus TXA in the prehospital setting. There was no difference in the number of pts experiencing seizure or outcome in those receiving the 2g bolus of TXA.
References
The Association Between Tranexamic Acid and Seizures in Moderate or Severe Traumatic Brain Injury
David V. Deshpande BS a, W. Ian McKinley MD, MS b, Andrew J. Benjamin MD, MS c, Martin A. Schreiber MD, FACS, FCCM d, Susan E. Rowell MD, MBA, MCR
Volume 301, September 2024, Pages 359-364 https://doi.org/10.1016/j.jss.2024.06.035