title: Tranexamic Acid as Antifibrinolytic Agent in Non Traumatic Intracerebral Hemorrhages.
abstract: BACKGROUND
  Mortality and morbidity associated with intracerebral hemorrhage is still high. Up to now, there are no evidence-based effective treatments for acute ICH. This study is to assess the effect of tranexamic acid (TXA) on hematoma growth of patients with spontaneous ICH compared to a placebo.
  
  
  METHODS
  We performed a single-blinded, randomised placebo-controlled trial of TXA (intravenous 1g bolus, followed by infusion TXA 1 g/hour for 8 hours) in acute (< 8 hours) primary ICH. Strict blood pressure control (target SBP 140-160 mmHg). A repeat Computed Tomography brain was done after 24 hours to reassess hematoma growth. The primary objective is to test the effect of TXA on hematoma growth. Other objective was to test the feasibility, tolerability, and adverse events of TXA in primary ICH.
  
  
  RESULTS
  Statistical analysis showed significant hematoma growth in control group after 24 hours compared to baseline (14.3300 vs 17.9940, P = 0.001) whereas the treatment group there is no significant hematoma size expansion between baseline and after 24 hours (P = 0.313).
  
  
  CONCLUSIONS
  This study showed a significant hematoma volume expansion in the control group compared to the treatment group.
authors.affiliation: Department of Neurosurgery, Hospital Queen Elizabeth II, PO Box 2029, 88586 Sabah, Malaysia.
authors.forename: Ananda
authors.initials: A
authors.lastname: Arumugam
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bharu, Johor, Malaysia.
authors.forename: Noor Azman
authors.initials: NA
authors.lastname: A Rahman
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bharu, Johor, Malaysia.
authors.forename: Sharon Casilda
authors.initials: SC
authors.lastname: Theophilus
authors.affiliation: Department of Neurosurgery, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bharu, Johor, Malaysia.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Shariffudin
authors.affiliation: Center for Neuroscience Services & Research, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Jafri Malin
authors.initials: JM
authors.lastname: Abdullah
keywords: antifibrinolytic agents; hypertension; non-traumatic intracerebral bleed; primary hypertensive hemorrhage; tranexamic acid