Document Detail


Hematogenous factors and prediction of delayed ischemic deficit after subarachnoid hemorrhage.
MedLine Citation:
PMID:  1412575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Delayed ischemic deficits contribute to the high morbidity and mortality rates associated with subarachnoid hemorrhage. We evaluated the potential usefulness of measuring coagulation and hemorheological variables and cardiolipin antibodies for prediction of delayed ischemic deficit after subarachnoid hemorrhage. METHODS: Consecutive patients with subarachnoid hemorrhage were studied. Coagulation and hemorheological variables and cardiolipin antibodies were measured on admission, within 7 days of subarachnoid hemorrhage. A subset of patients was studied on admission and at two subsequent occasions. RESULTS: Sixty-nine patients were studied. Sixty-one of these were without clinical manifestations of vasospasm at admission, and 16 developed delayed ischemic deficit during their hospitalization. None of the laboratory variables measured were significantly different between patients with or without later development of delayed ischemic deficit. Elevation of the fibrin fragment D-dimer was found in the group of eight patients admitted with ischemic symptoms and in 49% (34 of 69) of all patients, but this was not associated with delayed ischemic deficit. Sixteen patients were studied on three occasions; this group showed a significant decrease in hematocrit, an increased white blood cell count, and no change in fibrinogen concentration. Fibrin D-dimer levels rose significantly after surgery (from 5.01 +/- 0.69 to 5.53 +/- 0.58 ln-ng/ml, p less than 0.025) and after onset of delayed ischemic deficit (from 4.71 +/- 0.64 to 5.84 +/- 0.34 ln-ng/ml, p less than 0.01). CONCLUSIONS: Hemostatic measurements, hemorheological variables, and cardiolipin immunoreactivity did not predict delayed ischemic deficit in this population.
Authors:
S F Ameriso; V L Wong; H Ishii; F P Quismorio; S L Giannotta; H J Meiselman; M Fisher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  23     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-11-05     Completed Date:  1992-11-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1404-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Southern California School of Medicine, Los Angeles 90033.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antibodies, Anticardiolipin / analysis*
Brain Ischemia / etiology*
Female
Fibrin Fibrinogen Degradation Products / analysis*
Hematocrit
Humans
Leukocyte Count
Male
Middle Aged
Prognosis
Prospective Studies
Subarachnoid Hemorrhage / complications*
Grant Support
ID/Acronym/Agency:
HL-15722/HL/NHLBI NIH HHS; HL-41341/HL/NHLBI NIH HHS; R01-NS20989/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Anticardiolipin; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

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