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 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.
Palmer
J D
JD
Southampton University Hospitals, UK.
Francis
D A
DA
Roath
O S
OS
Francis
J L
JL
Iannotti
F
F
D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy; D004305:Dose-Response Relationship, Drug; D017809:Fatal Outcome; D005342:Fibrinolysis; D005909:Glioblastoma / Q000473:pathology / Q000601:surgery*; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011183:Postoperative Complications; D011516:Prothrombin; D013916:Thrombelastography; D013925:Thromboplastin
D011516:Prothrombin; D013925:Thromboplastin; D007611:Aprotinin