Coagulation and Fibrinolysis Abnormalities in the Acute Stage of Hypertensive Intracerebral Hemorrhage, with Special Reference to Fibrinopeptides A and Bβ15-42

Coagulation studies were performed in 11 patients in the acute stage of hypertensive intracerebral hemorrhage. The items tested include platelet count, prothrombin time, partial thromboplastin time, fibrinogen, antithrombin III, fibrin/fibrinogen degradation products, α2 macroglobulin, α2 plasmin inhibitor, fibrinopeptide A (FPA), and fibrinopeptide Bβ15-42 (FPBβ). Blood was collected from peripheral veins within 6 hours and again between the 7th and 14th days after the onset of symptoms. Disseminated intravascular coagulation (DIC) occurred in one patient, in whom the tests were repeated several times for 14 days. Fibrinopeptide levels were extremely high within 6 hours after the onset of symptoms and normalized between the 7th and 14th days. Fibrinopeptides were especially high in the patient with DIC, which was caused by primary brain damage. Normal FPA levels were restored sooner than those of the other substances after administration of heparin and gabexate mesilate. It appears that damage to cerebral tissue occasionally brings about DIC and that FPA and FPBβ may be excellent indices for predicting coagulation and fibrinolytic imbalance and for managing DIC.