OBJECTIVE: Hematoma growth is a major cause of poor outcome in patients with intracerebral hemorrhage. We evaluated the efficacy of a combination of rapid antifibrinolytic therapy and strict blood pressure control for prevention of hematoma growth in this retrospective study. METHODS: Systolic blood pressure was strictly controlled below 150 mm Hg by use of intravenously administered nicardipine (BPC). Prolonged infusion of antifibrinolytic therapy was given by intravenous administration of 1 g tranexamic acid over a period of 6 hours (PAF). Rapid administration of antifibrinolytic therapy was given by intravenous administration of 2 g tranexamic acid over a period of 10 minutes (RAF). Immediately after diagnosis of intracerebral hemorrhage on computed tomographic scan, 156 patients who were admitted within 24 hours of onset were treated with either a combination of PAF and BPC (PAF group) or a combination of RAF and BPC (RAF group). The incidence of hematoma growth determined by a second computed tomographic scan the day after admission was compared between the PAF and the RAF groups. RESULTS: Hematoma growth was observed in 11 (17.5%) of 63 patients in the PAF group and 4 (4.3%) of 93 patients in the RAF group using a 20% cutoff value for hematoma enlargement. The RAF group showed a significantly low incidence of hematoma growth compared with the PAF group (P < 0.05). Between the two groups, there was no significant difference in any of the other factors reported to affect hematoma growth. CONCLUSION: The combination of rapid administration of antifibrinolytics and strict blood pressure control may prevent hematoma growth in patients with intracerebral hemorrhage.
OBJECTIVE:Hematoma growth is a major cause of poor outcome in patients with intracerebral hemorrhage. We evaluated the efficacy of a combination of rapid antifibrinolytic therapy and strict blood pressure control for prevention of hematoma growth in this retrospective study. METHODS: Systolic blood pressure was strictly controlled below 150 mm Hg by use of intravenously administered nicardipine (BPC). Prolonged infusion of antifibrinolytic therapy was given by intravenous administration of 1 g tranexamic acid over a period of 6 hours (PAF). Rapid administration of antifibrinolytic therapy was given by intravenous administration of 2 g tranexamic acid over a period of 10 minutes (RAF). Immediately after diagnosis of intracerebral hemorrhage on computed tomographic scan, 156 patients who were admitted within 24 hours of onset were treated with either a combination of PAF and BPC (PAF group) or a combination of RAF and BPC (RAF group). The incidence of hematoma growth determined by a second computed tomographic scan the day after admission was compared between the PAF and the RAF groups. RESULTS:Hematoma growth was observed in 11 (17.5%) of 63 patients in the PAF group and 4 (4.3%) of 93 patients in the RAF group using a 20% cutoff value for hematoma enlargement. The RAF group showed a significantly low incidence of hematoma growth compared with the PAF group (P < 0.05). Between the two groups, there was no significant difference in any of the other factors reported to affect hematoma growth. CONCLUSION: The combination of rapid administration of antifibrinolytics and strict blood pressure control may prevent hematoma growth in patients with intracerebral hemorrhage.
Authors: Vincent Degos; Erick M Westbroek; Michael T Lawton; J Claude Hemphill; Gregory J Del Zoppo; William L Young Journal: Anesthesiology Date: 2013-07 Impact factor: 7.892
Authors: Zhe Kang Law; Atte Meretoja; Stefan T Engelter; Hanne Christensen; Eugenia-Maria Muresan; Solveig B Glad; Liping Liu; Philip M Bath; Nikola Sprigg Journal: Eur Stroke J Date: 2016-10-26
Authors: Katie Flaherty; Philip M Bath; Robert Dineen; Zhe Law; Polly Scutt; Stuart Pocock; Nikola Sprigg Journal: Trials Date: 2017-12-20 Impact factor: 2.279