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The pathogenesis of symptomatic vasospasm following subarachnoid hemorrhage is still unclear. To clarify this, we analized changes of blood coagulation activities between 65 poor risk aneurysmal patients treated by a combination with ticlopidine, albumin and nicardipine (so called TAN therapy) and in 52 untreated patients with symptomatic vasospasm. The hypercoagulable state was scored according to the Disseminated Intravascular Coagulation (DIC) scoring system. Our clinical studies showed that severe SAH following aneurysmal rupture caused the hypercoagulable state. There were good correlations between the degree of hypercoagulation and the severity of the symptomatic vasospasm. TAN therapy reduced the DIC scores by antiplatelet agent and prevented the occurrence of the symptomatic vasospasm in severe SAH. These facts support the beneficial effects of TAN therapy in prevention of symptomatic vasospasm in severe SAH.

Prevention of the Symptomatic vasospasm in Poor Risk Aneurysmal Patients by Ticlopidine, Albumin and Nicardipine (TAN-Therapy)