Which of the following patients would be considered high risk in the setting of closed head injury, and should be strongly considered for emergent head CT and ED transfer?
A. A 34-year-old woman who is 30 weeks pregnant and is receiving treatment doses of enoxaparin for DVT
B. A 54-year-old man who is taking low-dose aspirin for cardiovascular prophylaxis
C. An 8-year-old child with hemophilia A
D. All of the above
E. Both A and C
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Answer: E. The patients described in A and C are both at high risk due to coagulopathy. Regarding the patient described in B, regular-dose aspirin (325 mg) is considered to be a high-risk factor in the setting of head trauma, but there is evidence that low-dose aspirin (81 mg) does not increase the risk of intracranial injury in mild closed head injury.