Hyperfibrinolysis during intracranial surgery: effect of high dose aprotinin.

Authors:
  • DFD A Francis
    D A Francis
  • ORO S Roath
    O S Roath
  • JFJ L Francis
    J L Francis
  • FIF Iannotti
    F Iannotti
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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.