Antifibrinolytic Treatment in Subarachnoid Hemorrhage

Vermeulen, M.; Lindsay, Kenneth W.; Murray, Gordon D.; Cheah, Foong Koon; Hijdra, A.; Muizelaar, J. Paul; Schannong, M; Teasdale, Graham M.; Crevel, H. van; Gijn, J. van

doi:10.1056/nejm198408163110703

Cited by 275 publications

(139 citation statements)

References 19 publications

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“…142 In recent studies, poor neurological status, 142 high Hunt-Hess grade, and larger aneurysm diameter 143 were independent predictors of acute hydrocephalus, intraventricular blood, and the use of ventricular drains. [137][138][139][143][144][145][146][147] Recent data suggest that when preoperative ventriculostomy is followed by early treatment of the ruptured aneurysm, the risk of rebleeding is not increased by the ventriculostomy. 148 Numerous systems have been reported for grading the clinical outcome in patients with SAH from a ruptured intracranial aneurysm, but the current literature remains substantially deficient with respect to intraobserver and interobserver uniformity or consistency.…”

Section: Prevention Of Sah: Summary and Recommendationsmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,163

488

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Section: Prevention Of Sah: Summary and Recommendationsmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,163

488

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“…35 Outcome was assessed at 3 months according to the Glasgow Outcome Scale 36 by neurologists who were unaware of CT findings.…”

Section: -28mentioning

confidence: 99%

Infarction after aneurysm rupture does not depend on distribution or clearance rate of blood.

Brouwers¹,

Wijdicks²,

Gijn³

1992

Stroke

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Background and Purpose:We sought to determine the contribution of the amount, distribution, and clearance rate of extravasated blood in relation to occurrence of infarction and outcome in patients with aneurysmal subarachnoid hemorrhage.Methods: We prospectively studied 59 consecutive patients with aneurysmal subarachnoid hemorrhage admitted within 72 hours by means of serial computed tomographic scanning, close clinical observation, and assessment of outcome after 3 months.Results: Infarction occurred in 17 of the 59 patients. The arterial territories involved hardly reflected the distribution of subarachnoid blood in the basal cisterns on computed tomography, and even the side of the infarcts corresponded only weakly with the side on which most extravasated blood was seen. Infarction occurred twice as often in patients with large amounts of subarachnoid blood; this difference was not significant on its own but is in agreement with previous studies. A low clearance rate of cisternal blood was not related to the occurrence of infarction; a relation between clearance rate and poor outcome was largely explained by the amount of subarachnoid blood on the initial computed tomogram and by a low Glasgow Coma Scale score on admission.Conclusions: The fact that infarction is related to the total amount but not to the distribution or clearance rate of extravasated blood argues against a direct role of extravasated blood and in favor of systemic factors, dependent on the severity of the initial hemorrhage. (Stroke 1992;23:374-379) KEY WORDS • cerebral infarction • subarachnoid hemorrhage • tomography, x-ray computed

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“…Some studies support this result, giving tranexamic acid in patients with subarachnoid hemorrhage stroke as antifibrinolytic therapy revealed no significant differences in the parameters of the Glasgow outcome scale (GOS) between tranexamic acid and placebo groups [9][10][11].…”

Section: Discussionmentioning

confidence: 76%

The Correlation of Tranexamic Acid Used as Antifibrinolytic Therapy to Glasgow Coma Scale for the First 7 Days in Haemorrhagic Stroke Patients

Setiawan

Ikawati

Gofir

2017

Asian J Pharm Clin Res

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Objective: Treatment of hemorrhagic stroke using tranexamic acid is still used in some hospitals, to prevent the occurrence of the complication called rebleeding. Rebleeding is an important cause of bad outcomes that result loss of consciousness and even death. The administration of the antifibrinolytic tranexamic acid in patients with hemorrhagic stroke can reduce the occurrence of rebleeding, but it also can increase poor outcome caused by cerebral ischemia that can worsen the patient's condition. Methods:This study used observational study design, cohort, prospective, and multicenter. The purpose of this study was to determine the effectiveness of the use of tranexamic acid in patients with hemorrhagic stroke. Statistical testing is done by analyzing the Glasgow coma scale (GCS) score on day 1 st , day 3 rd , and day 7 th between the treatment groups hemorrhagic stroke patients who received tranexamic acid therapy as antifibrinolytic therapy in Bethesda Hospital for 23 patients compared with a control group of patients hemorrhagic stroke who did not receive therapy as tranexamic acid antifibrinolytic therapy in the Dr. Sardjito Hospital for 23 patients. Results:The statistical analysis of the independent t-test showed that there was no significant difference between the average GCS score of day 1 st (p=262), day 3 rd (p=0.293), and day 7 th (p=0.648) between treatment group and control group. The statistical analysis of the Mann-Whitney showed that there was not significant difference comparing the difference between the pre and post GCS score at treatment group and control group (p=0.158). Conclusion:Administration of tranexamic acid in patients with hemorrhagic stroke (treatment group) gives the same clinical response compared to the patients who did not receive tranexamic acid therapy (control group) based on assessment of the GCS score.

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Antifibrinolytic Treatment in Subarachnoid Hemorrhage

Cited by 275 publications

References 19 publications

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Infarction after aneurysm rupture does not depend on distribution or clearance rate of blood.

The Correlation of Tranexamic Acid Used as Antifibrinolytic Therapy to Glasgow Coma Scale for the First 7 Days in Haemorrhagic Stroke Patients

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