FIBRINOLYSIS AND SUBARACHNOID HAEMORRHAGE. INHIBITORY EFFECT OF TRANEXAMIC ACID A Clinical Study

In 4 patients with subarachnoid haemorrhage after ruptured intracranial aneurysm, tranexamic acid (AMCA) was used to prevent the recurrence of the bleeding. 1000 mg of AMCA was given intravenously 6 times a day for 8 days. The fibrinolytic activity of blood and spinal fluid was measured simultaneously with the etermination of AMCA levels before and after the beginning of treatment. The fibrin plate method showed no fibrinolytic activity in plasma or in CSF. Local fibriolysis was demonstrated by the presence of fibrin degradation products in spinal fluid. After repeated administration, AMCA crossed the blood‐brain barrier and effectively inhibited the local fibrinolysis within the spinal fluid. The findings in this study suggest that in patients with subarachnoid haemorrhage AMCA should be aministrated intravenously in a dosage of 15–20 mg/kg body weight 6 times a day as soon as possible after the bleeding. But treatment with the antifibrinolytic drug does not change the indication for surgical therapy.

[1]  I. Nilsson,et al.  Experimental and clinical studies on AMCA, the antifibrinolytically active isomer of p-aminomethyl cyclohexane carboxylic acid. , 2009, Scandinavian journal of haematology.

[2]  J. Gibbs,et al.  Use of an anti-fibrinolytic agent (tranexamic acid) in the management of ruptured intracranial aneurysms. , 1971, Postgraduate medical journal.

[3]  C. Thulin,et al.  The use of antifibrinolytic substances in ruptured intracranial aneurysms , 1969, Neurochirurgia.

[4]  S. Colleen,et al.  ROLE OF UROKINASE AND TISSUE ACTIVATOR IN SUSTAINING BLEEDING AND THE MANAGEMENT THEREOF WITH EACA AND AMCA , 1968, Annals of the New York Academy of Sciences.

[5]  Niléhn Je.  Separation and estimation split "products" of fibrinogen and fibrin in human serum. , 1967 .

[6]  P. O'gorman,et al.  Fibrinolysis in subarachnoid haemorrhage. , 1967, Postgraduate medical journal.

[7]  F. Beller,et al.  Comparative Studies of Fibrinolytic Inhibitors in Vitro , 1966, Thrombosis and Haemostasis.

[8]  J. Michenfelder,et al.  Deep hypothermia and surgical treatment of intracranial aneurysms. A five-year survey. , 1966, JAMA.

[9]  I. Nilsson,et al.  Fibrinolytic Activity in Man During Surgery , 1962, Thrombosis and Haemostasis.

[10]  P. Slosberg.  Medical treatment of intracranial aneurysm , 1960, Neurology.

[11]  D. Silver,et al.  Treatment of subarachnoid hemorrhage: the ability of epsilon aminocaproic acid to cross the blood brain barrier and reduce the spinal fluid fibrinolytic activity. , 1968, Surgical forum.

[12]  S. Mullan,et al.  Antifibrinolytic therapy for intracranial aneurysms. , 1968, Journal of neurosurgery.

[13]  J. Niléhn.  Separation and Estimation of Split “Products” of Fibrinogen and Fibrin in Human Serum , 1967, Thrombosis and Haemostasis.

[14]  J. Porter,et al.  Fibrinolytic activity of the spinal fluid and meninges. , 1966, Surgical forum.

[15]  M. Buckell,et al.  Biochemical changes after spontaneous subarachnoid haemorrhage Part III Coagulation and lysis with special reference to recurrent haemorrhage , 2022 .