Use of epsilon aminocaproic acid (EACA) in the preoperative management of ruptured intracranial aneurysms

Sengupta, R. P.; So, Sing Cho; Villarejo-Ortega, Francisco

doi:10.3171/jns.1976.44.4.0479

Cited by 76 publications

(23 citation statements)

References 22 publications

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“…In this situation, use of antifibrinolytic agents, ex pecting to prevent recurrent hemorrhage at least in a few postictal weeks, were widely accepted and there appeared many reports supporting its favorable results (5,15,18,19,22). Also possible complications have been extensively investigated.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Complication of Antifibrinolytic Therapy in the Treatment of Ruptured Intracranial Aneurysm

et al. 1980

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Among the reported complications of the antifibrinolytic therapy in the treatment of ruptured intracranial aneurysms, nausea and vomiting, cerebral arteriopathy and secondary hydrocephalus would be a matter of concern in its possible CNS involvement. However, little is known about the possibility of direct cerebral effect in synthetic antifibrinolytics. A simply designed animal experiment disclosed remarkable effects on electroencephalography, blood flow of the cerebral cortex and intracranial pressure. Such antifibrinolytics should not be given intrathecally in any situation even if the accumulation of the agents in cerebrospinal fluid is essential to prevent recurrent hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Cerebral Complication of Antifibrinolytic Therapy in the Treatment of Ruptured Intracranial Aneurysm

et al. 1980

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“…4 None of the previous studies was controlled or doubleblind. Sengupta et al 10 reported good results with antifibrinolytic treatment on the re-bleeding rate in a controlled trial but they did not report the effect of the treatment on mortality and their control group comprised more severely ill patients than their active treatment group. In their active treatment group only 8 of 66 patients were not operated on, while in the control group, in 31 of 76 patients, there was reason to refrain from surgery making their groups non-comparable.…”

Section: Discussionmentioning

confidence: 99%

“…2 ' 3 Antifibrinolytic agents have been employed to reduce the risk of re-bleeding after subarachnoid hemorrhage. 4 " 10 We have evaluated the effects of the antifibrinolytic agent tranexamic acid in patients with subarachnoid hemorrhage.…”

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confidence: 99%

“…Patients were suspected of having a recurrent hemorrhage if they showed 2 or more of the following signs: 1) sudden deterioration in their level of consciousness, 2) increase in the degree of neck rigidity, 3) increase in severity of headache, 4) sudden appearance of fresh neurological deficits or further progression of existing ones. 10 The lumbar puncture was not repeated in 12 patients whose clinical evidence of recurrent hemorrhage was convincing as the care of a seriously ill patient was the chief concern. In 3 of these, re-bleeding was confirmed by necropsy.…”

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confidence: 99%

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Tranexamic acid in subarachnoid hemorrhage. A double-blind study.

Kaste¹,

Ramsay²

1979

Stroke

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SUMMARY The effects of intravenous tranexamic acid were compared with placebo in 64 patients with subarachnoid hemorrhage. A double-blind procedure was used. One gram of tranexamic acid was given intravenously every 4 hours up to the time of operation on an intracranial arterial aneurysm or for up to 21 days after the first bleeding if operative treatment was not feasible. There were no differences in re-bleeds, morbidity or mortality between the tranexamic and placebo-treated groups. No thromboemboiic complications were noted in either group. Our results do not support the use of tranexamic acid in subarachnoid hemorrhage in daily doses of 6 g.

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“…However, given after a subarachnoid hemorrhage, EACA has been reported to cause middle cerebral artery thrombosis. 17 Our patient was obese, a state associated with hyperestrogenism, 18 which is a known risk factor for hypercoagulability. Theoretically, this could have made her more susceptible to the development of cerebral sinus thrombosis during EACA administration.…”

Section: Discussionmentioning

confidence: 99%

Cerebral sinus thrombosis as a potential hazard of antifibrinolytic treatment in menorrhagia.

Achiron

Gornish

Melamed

1990

Stroke

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We describe a 42-year-old woman who developed superior sagittal and left transverse sinus thrombosis associated with prolonged c-aminocaproic acid therapy for menorrhagia. This antifibrinolytic agent has been used in women with menorrhagia to promote clotting and reduce blood loss. Although increased risk of thromboembolic disease has been reported during treatment with c-aminocaproic acid, cerebral sinus thrombosis has not been previously described. Careful use of c-aminocaproic acid therapy is recommended. (Stroke 1990^1:817-819)

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Use of epsilon aminocaproic acid (EACA) in the preoperative management of ruptured intracranial aneurysms

Cited by 76 publications

References 22 publications

Cerebral Complication of Antifibrinolytic Therapy in the Treatment of Ruptured Intracranial Aneurysm

Cerebral Complication of Antifibrinolytic Therapy in the Treatment of Ruptured Intracranial Aneurysm

Tranexamic acid in subarachnoid hemorrhage. A double-blind study.

Cerebral sinus thrombosis as a potential hazard of antifibrinolytic treatment in menorrhagia.

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