Hyperfibrinolysis during intracranial surgery: effect of high dose aprotinin

A patient undergoing intracranial surgery developed disseminated intravascular coagulation with life threatening peroperative bleeding. Thromboelastography established the diagnosis of hyperfibrinolysis, usually a fatal complication of a neurosurgical operation. With the administration of a high dos...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1995-01, Vol.58 (1), p.104-106
Main Authors: Palmer, J D, Francis, D A, Roath, O S, Francis, J L, Iannotti, F
Format: Article
Language:English
Subjects:
Aged
Aprotinin - administration & dosage
Aprotinin - therapeutic use
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Brain - pathology
Brain - surgery
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Craniotomy
Dose-Response Relationship, Drug
Fatal Outcome
Fibrinolysis
Glioblastoma - pathology
Glioblastoma - surgery
Hemorrhage - drug therapy
Humans
Injections, Intravenous
Male
Medical sciences
Pharmacology. Drug treatments
Postoperative Complications
Prothrombin
Thrombelastography
Thromboplastin
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Summary:A patient undergoing intracranial surgery developed disseminated intravascular coagulation with life threatening peroperative bleeding. Thromboelastography established the diagnosis of hyperfibrinolysis, usually a fatal complication of a neurosurgical operation. With the administration of a high dose regimen of aprotinin (Trasylol) the haemorrhage was controlled and the hyperfibrinolytic state reversed. Evaluation of blood samples from the jugular bulb suggested that there was a pronounced local release of tissue plasminogen activator into the circulation.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.58.1.104