The emerging role of brain-derived microparticles in trauma-induced coagulopathy after traumatic brain injury

Traumatic brain injury (TBI) is frequently complicated by trauma-induced coagulopathy (TIC), which contributes substantially to secondary brain injury and poor clinical outcomes. The mechanisms underlying traumatic brain injury induced coagulopathy (TBI-IC) are multifactorial and involve extensive cellular alterations in endothelial cells, neutrophils, and platelets. Brain-derived microparticles (BDMPs), a subgroup of extracellular vesicles derived from brain-associated cells, attracted increasing attention due to their potential involvement in coagulation regulation after TBI. This review summarizes current evidence regarding the biological characteristics of BDMPs, their proposed contributions to coagulation abnormalities, inflammatory responses, and vascular dysfunction following TBI, as well as their potential value as biomarkers and therapeutic targets. In addition, the limitations of current evidence, including methodological heterogeneity, insufficient clinical validation, and uncertainties regarding causal mechanisms, are discussed to provide a balanced perspective on the translational potential of BDMPs in TBI-IC.