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Hyperfibrinolysis during intracranial surgery: effect of high dose aprotinin.
  1. J D Palmer,
  2. D A Francis,
  3. O S Roath,
  4. J L Francis,
  5. F Iannotti
  1. Southampton University Hospitals, UK.


    A patient undergoing intracranial surgery developed disseminated intravascular coagulation with life threatening peroperative bleeding. Thromboelastography established the diagnosis of hyperfibrinolysis, usually a fatal complication of a neurosurgical operation. With the administration of a high dose regimen of aprotinin (Trasylol) the haemorrhage was controlled and the hyperfibrinolytic state reversed. Evaluation of blood samples from the jugular bulb suggested that there was a pronounced local release of tissue plasminogen activator into the circulation.

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