| Abstract [eng] |
Tranexamic acid is increasingly used in surgical practice due to its haemostatic properties and favorable safety profile. The aim of this paper is to explore the potential of this drug in neurosurgery based on the latest evidence, and to compare current clinical guidelines, highlighting potential areas for improvement. A systematic literature review was performed by analyzing systematic reviews published in the PubMed database between 2020 and 2025 related to the use of tranexamic acid in neurosurgical procedures. The most relevant international and national clinical guidelines on the use of tranexamic acid in surgery, including specific neurosurgical procedures, were also analyzed. The results showed that tranexamic acid is effective in traumatic brain injury, especially when administered as early as possible after injury. It is also safe and effective in spinal surgery and paediatric surgery. The data show that tranexamic acid use is not significantly associated with an increased risk of thromboembolic events. In comparing the current guidelines, it is suggested to revise the dosing recommendations for tranexamic acid in trauma, to include recommendations for the use of topical tranexamic acid in neurosurgery, and to clarify the use of tranexamic acid in the paediatric population. It is recommended to continue studies on the safety and efficacy of the drug in the surgical treatment of subarachnoid haemorrhages and to assess the incidence of potential adverse events depending on the dosage. |
