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Reduced clot-stability during the first 6hours after aneurysmal subarachnoid haemorrhage - a prospective case-control study.
MedLine Citation:
PMID:  22386137     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Early rebleeding is an important cause of death and disability following aneurysmal subarachnoid haemorrhage (SAH). Recent studies have shown that 50-90% of the rebleedings occurred within the first 6hours after the primary bleeding. The mechanism leading to rebleeding remains to be established. In the present prospective case-control study we hypothesize that patients with SAH develop a coagulopathy characterized by reduced clot stability during the early period after the initial bleeding. METHODS: Patients with aneurysmal SAH was studied with a dynamic clot lysis assay and markers of fibrinolysis and clot stabilizers in blood samples taken within and after 6hours after onset of bleeding. Results were compared with blood samples from age and gender matched healthy controls. RESULTS: 36 patients were enrolled, 26 patients had blood samples collected within 6hours after the initial bleeding whereas 10 patients had blood samples taken later than 6hours after the initial bleeding. Patients demonstrated significantly reduced clot stability during the first 6hours after initial bleeding. Fibrinolytic activity was increased during the first 6hours along with the inhibitors of fibrinolysis whereas the modulators of fibrinolysis were reduced or inactivated. CONCLUSION: During the first 6hours after SAH patients exhibit reduced clot-stability. Probably a consequence of activated fibrinolysis in combination with reduced or inactivated factor XIII and thrombin-activable fibrinolysis inhibitor.
Carl C Larsen; Benny Sørensen; Jørn D Nielsen; Jens Astrup
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-2
Journal Detail:
Title:  Thrombosis research     Volume:  -     ISSN:  1879-2472     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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