Intracranial Bleeding during Treatment with Hydroxyethyl Starch

Abstract

To the Editor: Intravascular volume expansion to prevent intracranial arterial spasm is a well-established treatment for intracranial hemorrhage.^{1 2 3} The use of hetastarch (hydroxyethyl starch) to expand plasma volume is now a common practice in neurosurgery. In normal volunteers, coagulation abnormalities have been associated with the administration of hetastarch,^{4 , 5} and minor bleeding in neurosurgical patients receiving this agent has recently been reported.⁶ We report a case of coagulopathy with ititracranial hemorrhage in a patient treated with hetastarch.A 36-year-old woman was admitted with a severe headache following a syncopal episode. CT scanning revealed a subarachnoid hemorrhage, and cerebral angiography demonstrated an . . .