Anti-fibrinolytic treatment in the pre-operative management of subarachnoid haemorrhage caused by ruptured intracranial aneurysm.

Abstract

Patients [100] treated with e-aminocaproic acid, 24 g daily prior to surgery, for ruptured intracranial aneurysms were compared with the previous 100 patients managed similarly but without anti-fibrinolytic drugs. No other alterations in management were made and the 2 series are closely comparable in all other respects. Fewer episodes of recurrent hemorrhage and deaths from this cause occurred in the treated patients, but more cases of cerebral ischemia occurred. Neither difference is statistically significant and overall more deaths occurred in the patients treated with antifibrinolytic drugs. The value of this method of treatment in the management of aneurysmal subarachnoid hemorrhage is questioned.