Changes in coagulative and fibrinolytic activities in patients with intracranial hemorrhage.
OBJECTIVE
To investigate whether any changes occur in the coagulative/fibrinolytic cascade in patients with subarachnoid hemorrhage (SAH) or hypertensive intracerebral hemorrhage (HICH).


METHODS
Subjects included 143 patients with intracranial hemorrhage (SAH, n = 50; HICH, n = 82; ROSC-SAH [return of spontaneous circulation after cardiopulmonary arrest due to SAH], n = 11). Coagulative and fibrinolytic factors were measured in blood samples taken on admission.


RESULTS
The prothrombin fragment 1+2 level was significantly higher (p < 0.005) in SAH patients than in HICH patients. The fibrinolytic factors (plasmin alpha 2-plasmin inhibitor complex, D-dimer, or fibrinogen degradation products) in SAH and ROSC-SAH were both significantly higher than those in HICH, but the significance of difference was stronger in the case of ROSC-SAH (p < 0.05).


CONCLUSIONS
Both coagulative and fibrinolytic activities were altered after the onset of SAH. These results demonstrate that the coagulative/fibrinolytic cascade might be activated via different mechanisms in different types of stroke. It remains unclear, however, whether a significant alteration of the fibrinolytic cascade in patients with ROSC-SAH might be a nonspecific phenomenon attributable to the reperfusion after collapse.
Ebihara
T
T
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan. ebi@med.nihon-u.ac.jp
Kinoshita
K
K
Utagawa
A
A
Sakurai
A
A
Furukawa
M
M
Kitahata
Y
Y
Tominaga
Y
Y
Chiba
N
N
Moriya
T
T
Nagao
K
K
Tanjoh
K
K