Antifibrinolytics in aneurysmal subarachnoid haemorrhage. A retrospective comparison of two different forms of antifibrinolytic therapy.

The results of two different antifibrinolytic therapeutic modalities (A = AMCA 3 gm daily + Aprotinin, 3-400000 K.I.U. daily, B = AMCA, 6 gm daily) were compared retrospectively in a series of 137 patients harbouring recently ruptured intracranial aneurysms. The rates for rebleeding and thromboembolic complications were similar in both differently treated groups of patients, whilst that for ischaemic complications was significantly (p less than 0.025) lower in cases managed with modality A. In these also the incidence of hydrocephalus was decreased, although not significantly (0.20 greater than p greater than 0.19). According to these data, low-dose AMCA + Aprotinin seems to be a rational therapeutic combination for cases of ruptured intracranial aneurysms, in which antifibrinolytics are indicated.