Factors affecting coagulation: fibrinolysis in chronic subdural fluid collections.
Plasminogen, alpha2-antiplasmin, fibrinogen, fibrin degradation products (FDP's), and hemoglobin were measured in the supernatant fluid of 25 chronic subdural hematomas and five chronic subdural hygromas. The 30 patients underwent pre- and postoperative computerized tomography. The hematomas were characterized by low fibrinogen and high fibrin degradation product concentrations. The hemoglobin content varied directly with the alpha2-antiplasmin, and inversely with the plasminogen. Four patients underwent reoperation for recurrences. The initial fluid from these cases was characterized by relatively high plasminogen and low alpha2-antiplasmin. The hygromas had no hemoglobin, and low fibrinogen, high FDP's, low alpha2-antiplasmin, and variable plasminogen levels. It is possible that those cases having the greatest capacity to produce plasmin (high plasminogen and low alpha2-antiplasmin) can produce more FDP's which in turn causes more rebleeding and an increased risk of reaccumulation of chronic subdural hematomas.
D002908:Chronic Disease; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis; D006408:Hematoma, Subdural / Q000097:blood* / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010958:Plasminogen / Q000032:analysis; D000979:alpha-2-Antiplasmin / Q000032:analysis
D005338:Fibrin Fibrinogen Degradation Products; D006454:Hemoglobins; D000979:alpha-2-Antiplasmin; D005340:Fibrinogen; D010958:Plasminogen