Coagulation and Fibrinolysis in Blood and Cerebrospinal Fluid After Aneurysmal Subarachnoid Haemorrhage: Effect of Tranexamic Acid (AMCA)

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 1981 Jan 1

PMID 7195642

Citations 9

Authors

H Fodstad

I M Nilsson

Affiliations

Soon will be listed here.

Abstract

Serial assays of blood coagulation factors as well as of fibrin/fibrinogen degradation products (FDP) and plasminogen activatory activity (PA) on fibrin plates in blood and cerebrospinal fluid (CSF) were performed in 41 consecutive patients with recently ruptured cerebral aneurysms, 21 of whom were randomly treated with tranexamic acid (AMCA). Coagulation factors were unaffected by the drug and plasminogen and FDP decreased in blood after two weeks' treatment. After one week, PA in CSF was increased in control patients and unchanged in AMCA-treated patients, whereas CSF-FDP had decreased among AMCA-treated patients. After two weeks PA as well as FDP in CSF showed the same values in both groups. An increase in CSF-FDP occurred after rebleeding and in patients with cerebral ischaemic symptoms. The results indicate that AMCA inhibits local fibrinolysis in CSF in patients with aneurysm rupture.

Citing Articles

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Antifibrinolytic therapy to prevent early rebleeding after subarachnoid hemorrhage.

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Endogenous fibrinolysis in neonatal cerebrospinal fluid.

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References

Anderson M, Matthews K, Stuart J . Coagulation and fibrinolytic activity of cerebrospinal fluid. J Clin Pathol. 1978; 31(5):488-92. PMC: 1145309. DOI: 10.1136/jcp.31.5.488. View

NILEHN J . Split products of fibrinogen after prolonged interaction with plasmin. Thromb Diath Haemorrh. 1967; 18(1-2):89-100. View

Uttley A, BUCKELL M . Biochemical changes after spontaneous subarachnoid haemorrhage. 3. Coagulation and lysis with special reference to recurrent haemorrhage. J Neurol Neurosurg Psychiatry. 1968; 31(6):621-7. PMC: 496433. DOI: 10.1136/jnnp.31.6.621. View

Okamoto S, Oshiba S, Mihara H, OKAMOTO U . Synthetic inhibitors of fibrinolysis: in vitro and in vivo mode of action. Ann N Y Acad Sci. 1968; 146(2):414-29. DOI: 10.1111/j.1749-6632.1968.tb20303.x. View

Abiko Y, Iwamoto M . Plasminogen-plasmin system. VII. Potentiation of antifibrinolytic action of a synthetic inhibitor, tranexamic acid, by alpha 2-macroglobulin antiplasmin. Biochim Biophys Acta. 1970; 214(3):411-8. View

Collen D, Tytgat G, Claeys H, Piessens R . Metabolism and distribution of fibrinogen. I. Fibrinogen turnover in physiological conditions in humans. Br J Haematol. 1972; 22(6):681-700. DOI: 10.1111/j.1365-2141.1972.tb05715.x. View

Gerdin B, SALDEEN T . Effect of fibrin degradation products on microvascular permeability. Thromb Res. 1978; 13(6):995-1006. DOI: 10.1016/0049-3848(78)90228-1. View

Wieczorek V, Brodkorb W, REMDE W . [Subarachnoid hemorrhages associated with increased fibrinolysis]. Munch Med Wochenschr. 1970; 112(9):366-9. View

Watanabe H, Ishii S, Matsuda T . [Studies on the fibrinolytic system in ruptured intracranial aneurysm.--Part 2: Fibrinogen changes in acute stage of SAH as a risk factor of the ischemic complications following vasospasm (author's transl)]. No Shinkei Geka. 1978; 6(6):563-9. View

10.

SALDEEN T . Trends in microvascular research. The microembolism syndrome. Microvasc Res. 1976; 11(2):227-59. DOI: 10.1016/0026-2862(76)90054-6. View

11.

Vilchez J, Aznar J, Benedito J, Tascon A, Gonzalez A, Jimenez C . [Local fibrinolysis in cerebral and subarachnoid hemorrhage]. Rev Clin Esp. 1978; 150(3-4):193-5. View

12.

Tovi D, Nilsson I, THULIN C . Fibrinolytic activity of the cerebrospinal fluid after subarachnoid haemorrhage. Acta Neurol Scand. 1973; 49(1):1-9. DOI: 10.1111/j.1600-0404.1973.tb01274.x. View

13.

Tovi D, Nilsson I, THULIN C . Fibrinolysis and subarachnoid haemorrhage. Inhibitory effect of tranexamic acid. A clinical study. Acta Neurol Scand. 1972; 48(4):393-402. DOI: 10.1111/j.1600-0404.1972.tb07561.x. View

14.

Watanabe H, Ito M, CHIGASAKI H, Ishii S . Antifibrinolytic therapy in ruptured intracranial aneurysm through repeated monitoring of fibrinolytic activity of blood. Neurol Med Chir (Tokyo). 1976; 16(PT1):91-6. DOI: 10.2176/nmc.16pt1.91. View

15.

Brueton M, Breeze G, Stuart J . Fibrin-fibrinogen degradation products in cerebrospinal fluid. J Clin Pathol. 1976; 29(4):341-4. PMC: 476059. DOI: 10.1136/jcp.29.4.341. View

16.

MALOFIEJEW M . The biological and pharmacological properties of some fibrinogen degradation products. Scand J Haematol Suppl. 1971; 13:303-10. DOI: 10.1111/j.1600-0609.1971.tb02026.x. View

17.

Maurice-Williams R . Prolonged antifibrinolysis: an effective non-surgical treatment for ruptured intracranial aneurysms?. Br Med J. 1978; 1(6118):945-7. PMC: 1603860. DOI: 10.1136/bmj.1.6118.945. View

18.

Mihara H, Fujii T, Okamoto S . Fibrinolytic activity of cerebro-spinal fluid and the development of artificial cerebral haematomas in dogs. Thromb Diath Haemorrh. 1969; 21(2):294-303. View

19.

Gibbs J, OGorman P . Fibrinolysis in subarachnoid haemorrhage. Postgrad Med J. 1967; 43(506):779-84. PMC: 2466423. DOI: 10.1136/pgmj.43.506.779. View

20.

Levy B, Silver D . Treatment of subarachnoid hemorrhage: the ability of epsilon aminocaproic acid to cross the blood brain barrier and reduce the spinal fluid fibrinolytic activity. Surg Forum. 1968; 19:413-4. View