Hyperfibrinolysis during intracranial surgery: effect of high dose aprotinin.

Palmer, J D; Francis, D A; Roath, O S; Francis, J L; Iannotti, F · J Neurol Neurosurg Psychiatry · 1995

case_report · Level V

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Abstract

A patient undergoing intracranial surgery developed disseminated intravascular coagulation with life threatening peroperative 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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