Coagulation Abnormalities in Subarachnoid Hemorrhage

Coagulation and fibrinolytic studies were performed in 30 subarachnoid hemorrhage patients and 30 age-matched and sex-matched controls. Systemic abnormalities were detected in the following tests: recalcification time, fibrinogen, partial thromboplastin time, K value of thromboelastogram and euglobulin lysis time. The data suggest that subarachnoid hemorrhage patients with fibrinogen values over 400 mg% have a low probability of survival. Test abnormalities probably reflect tissue damage and/or meningeal reaction to the subarachnoid hemorrhage. Similar abnormalities can be noted in patients with cerebral trauma and in some patients with nonhemorrhagic cerebrovascular disease.1 Our data reveal that subarachnoid hemorrhage patients may exhibit simultaneously evidence suggesting increased coagulability and activation of fibrinolytic mechanisms. Under these circumstances administration of agents to suppress lytic activity might lead to disastrous consequences such as widespread intervascular coagulation (consumption coagulopathy).