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Hyperfibrinolysis during intracranial surgery: effect of high dose aprotinin.

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Published:1st Jan 1995
Author: Palmer JD, Francis DA, Roath OS, Francis JL, Iannotti F.
Availability: Free full text
Ref.:J Neurol Neurosurg Psychiatry. 1995;58(1):104-6.
DOI:10.1136/jnnp.58.1.104

A patient undergoing intracranial surgery developed disseminated intravascular coagulation with life threatening perioperative bleeding. Thromboelastography established the diagnosis of hyperfibrinolysis, usually a fatal complication of a neurosurgical operation.

With the administration of a high dose regimen of aprotinin (Trasylol) the haemorrhage was controlled and the hyperfibrinolytic state reversed. Evaluation of blood samples from the jugular bulb suggested that there was a pronounced local release of tissue plasminogen activator into the circulation.

 

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