[Coagulation-fibrinolytic abnormality and symptomatic vasospasm in the acute stage of ruptured cerebral aneurysms--analysis of alpha 2 PI, alpha 2 PIC, FDP and D.dimer].

Abstract In this study, alpha 2 plasmin inhibitor (alpha 2 PI), alpha 2 PI-plasmin complex (alpha 2 PIC), FDP (Fibrinogen/Fibrin Degradation Product) and D.Dimer were analyzed to confirm their clinical usefulness for estimation of symptomatic vasospasm and outcome. That included 34 patients operated on by clipping of aneurysm within 48 hours after onset. The patients were divided into two or three groups for each of the following items: Subarachnoid hemorrhage; Group A1 (Fisher's classification 1 and 2) and Group A2(3) and Group A3(4), Preoperative grade; Group B1 (Hunt and Kosnik I and II) and Group B2 (III and IV), Symptomatic vasospasm; Group C1 (present) and Group C2 (absent), Outcome; Group D1 (good recovery, moderate disability) and Group D2 (severe disability, vegetable). Peripheral venous blood was collected on the day before operation (Day 0) and first, second, 5th, 7th, 10th, 14th, 21st day after operation. Results are following. alpha 2 PI was found to change without significant intergroup or intragroup difference. alpha 2 PIC was significantly higher in A2 group than A1 group at 0 and 2nd day (p less than 0.05), in B2 group than B1 group at 0 day (p less than 0.05) and in C1 group than C2 group at 0 day and 5th day (p less than 0.05). Namely, alpha 2 PIC was already high before operation in patients with severe subarachnoid hemorrhage, poorer grade and/or symptomatic vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)