ORIGINAL PAPERS   

Journal of Neurosurgical Sciences 1998 September;42(3):131-6

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: English

A study on hemostasis parameters in the neurosurgery of cerebral aneurysms

Carelli E. F., Facure J. J., Norato D. I., Annichinno Bizacchi J. M.

Department of Neurology and *Hematology, Medical School, University of Campinas-Unicamp-Campinas, Brazil

Background. This pros­pec­tive ­study ­was accom­plished ­with 14 ­patients, 10 wom­en ­and 4 ­men, ­where ­some ­pre-, ­intra- ­and imme­di­ate post­op­er­a­tive param­e­ters of hemo­sta­sis ­were ana­lyzed ­and com­pared to a con­trol ­group of nor­mal indi­vid­u­als.
Methods. The ­patients includ­ed in ­this ­study ­were admit­ted to ­the Hospital ­das Clinicas at Unicamp in ­the 1990-1993 peri­od. All ­the accept­ed ­patients ­have ­had ­their lat­est bleed­ing at ­least 30 ­days ­before sur­gery, there­fore, ­after ­the ­acute bleed­ing ­phase, ­because in ­this ­phase ­there ­are alter­a­tions in hemostasis. In ­this peri­od ­only dip­y­rone ­was ­used in ­all ­patients as anal­ge­sics ­and anti­py­ret­ics. Opiates ­were ­used in ­all ­the anes­thet­ic pro­ceed­ings. The fol­low­ing param­e­ters ­were deter­mined: coagulation; prothrombin time, (PT), thrombin time, (TT), activated partial thromboplastin time, (­APTT), platelets (PQ), fibrinogen, (FG) factor V, ( F V), protein C, (P C), protein S (PS), antithrombin ­III (AT ­III); fibrinolysis, plasminogen (­PLG), C 1 inhibitor (C 1), alfa 2 mac­ro­glob­u­lin (A2M), prekallikrein (PK), euglobulin lysis time (­ELT), lysis area in fibrin plates (­LAFP), in 5 of ­these 14 ­patients. Activity of ­both plasminogen tissue activator (t-PA) ­and plasminogen activator inhibitor (­PAI-1) ­were ­also deter­mined. For ana­lyze the hepatic function pre-albu­min (­PRE ­ALB) ­was deter­mined.
Results ­and con­clu­sions. In ­this ­study, ­the anal­y­sis of ­LAFP ­and ­ELT in ­the dif­fer­ent sur­gi­cal ­times sug­gests ­that ­the ­patients sub­mit­ted to cere­bral aneu­rysm sur­gery ­are ­head to hyp­o­fib­ri­nol­y­sis ­from ­the intra­op­er­a­tive to ­the imme­di­ate post­op­er­a­tive peri­od ­and ­this evi­dence do ­not relat­ed ­whit ­PAI-1.