Treatment of acute intracerebral hemorrhage with epsilon-aminocaproic acid: a pilot study.
BACKGROUND
Up to 40% of primary intracerebral hemorrhages (ICHs) expand within the first 24 hours (natural history). The authors aimed to study the safety and preliminary efficacy of epsilon-aminocaproic acid (EACA) in halting ICH enlargement.


METHODS
Consecutive patients with hematoma volumes ranging from 5 to 80 mL were recruited within 12 hours of ICH onset. A total of 5 g EACA was infused during 1 hour and then 1 g/hour for 23 hours. Hematoma volume was compared on baseline, and 24-48-hour brain imaging. Consecutive untreated patients underwent the same imaging protocol.


RESULTS
Three of the first five patients treated had HE>33% of their baseline volume. HE occurred in two of the nine untreated patients. The 80% confidence interval for HE in the treated patients was 32-88%. No thrombotic or other serious adverse events were attributed to EACA.


CONCLUSIONS
It is unlikely that the rate of HE in patients given EACA within 12 hours of ICH is less than the natural history rate, although this treatment appears to be safe.
Piriyawat
Paisith
P
Stroke Program, Department of Neurology, University of Texas at Houston, Houston, TX 77030, USA.
Morgenstern
Lewis B
LB
Yawn
David H
DH
Hall
Christiana E
CE
Grotta
James C
JC
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015119:Aminocaproic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011859:Radiography; D017211:Treatment Failure
D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid