medigraphic.com
ISSN 2448-8909 (Print)

2000, Number 4

<< Back Next >>

Med Crit 2000; 14 (4)

Disseminated intravascular coagulation associated to severe cerebral injury

Carrillo ER, Hernández RA, González SJA

Language: Spanish
References: 27
Page: 142-146
PDF size: 105.31 Kb.


ABSTRACT

Objective: To describe the association between severe cerebral injury and disseminated intravascular coagulation (DIC).
Design: Case series report.
Setting: ICU of a tertiary care hospital, Mexico City.
Patients: Four previously healthy patients with severe cerebral injury following cranial trauma.
Interventions: Fresh frozen plasma, cryoprecipitates and platelets were administrated. One patient was undergone to cranial surgery.
Measurements and main results: Thrombocytopenia, prolonged TP, PTT and TT, low level of fibrinogen, elevated D dimer and fibrin degradation products was observed. All the patients died and the postmortem study revealed fibrin thrombi in glomeruli and pulmonary microcirculation.
Conclusion: Patients with severe brain injury associated to DIC have elevated mortality rate.


REFERENCES

  1. Bowers SA, Marshall LF. Outcome in 200 consecutive cases of severe head injury treated in San Diego county: a prospective analysis. Neurosurgery 1980;6:237.

  2. Miller JD, Becker DP, Ward JD et al. Significance of intracranial hypertension in severe head injury. J Neurosurgery 1977;47:501.

  3. Rosner MJ, Newsome HH, Becker DP. Mechanical brain injury: the sympathoadrenal response. J Neurosurg 1984;61:76.

  4. Berman IR, Ducker TB. Pulmonary, somatic and splanchnic circulatory responses to increased intracranial pressure. Ann Surg 1969;169-210.

  5. Ayus JC, Krothapalli RK, Arieff AI. Treatment of symptomatic hyponatremia and its relation to brain damage. N Engl J Med 1987;317:1190.

  6. Yoshino E, Yamaki T, Higuchi T et al. Acute brain edema in fatal head injury: analysis by dynamic CT scanning. J Neurosurg 1985;63:830.

  7. Miller JD, Betterworth JF, Guderman SK et al. Further experiences in the management of severe head injury. J Neurosurg 1981;54-289.

  8. Clark JA, Finelli RE, Netsky MG. Disseminated intravascular coagulation following cranial trauma. J Neurosurg 1980;52:266.

  9. Messmore HL Jr, Godwin J. Medical assessment of the bleeding surgical patient. Med Clin North Am 1994;78:625.

  10. Feinstin DI. Treatment of disseminated intravascular coagulation. Semin Thromb Hemost 1988;14:351.

  11. Bick RL. Disseminated intravascular coagulation: objective criteria for diagnosis and management. Med Clin North Am 1994;78:545.

  12. Eeles GH, Sevitt S. Microthrombosis in injured and burned patients. J Pathol Bact 1967;93:275-293.

  13. McGehee WG, Rapaport ST. Systemic hemostatic failure in the severely injured patient. Surg Clin North Am 1968;48:1247-1256.

  14. Keimowitz R, Annis B. Disseminated intravascular coagulation associated with massive brain injury. J Neurosurg 1973;39:178-180.

  15. Druskin MS, Drijansky R. Afibrinogenemia with severe head trauma. JAMA 1972;219:755-756.

  16. Goodnight SH, Kenoyer G, Rapapert Dsi et al. Defibrination after brain tissue destruction a serious complication of head injury. N Eng J Med 1974;290:1043-1047.

  17. James L, McGauley JL, Carole A, Miller CA, Penner JA. Diagnosis and treatment of diffuse intravascular coagulation following cerebral edema. J Neurosurg 1975;43: 374-376.

  18. Drayer BP, Poser CM. Disseminated intravascular coagulation and head trauma. Two case studies. JAMA 1975;231:174-175.

  19. McGauley JL, Miller CA, Penner JA. Diagnosis and treatment of diffuse intravascular coagulation following cerebral trauma. Case report. J Neurosurg 1975;43: 374-376.

  20. Vecht CJ, Smit Sibinga CT, Minderhoud JM. Disseminated intravascular coagulation and head injury. J Neurol Neurosurgery Psychiatry 1975;38:567-571.

  21. Vardi Y, Streifler M, Schujman E et al. Diffuse intravascular clotting associated with a primary brain tumor. J Neurol Neurosurg Psychiatry 1974;37:987-990.

  22. Matjasko MJ, Ducker TB. Disseminated intravascular coagulation associated with removal of a primary brain tumor. Case report. J Neurosurg 1977;47:475-480.

  23. Bang UN, McDowell F. Cerebral infarction and blood clotting. Trans Am Neurol Assoc 1966;91:84-86.

  24. Preston FE, Malia RG, Sworn MU et al. Disseminated intravascular coagulation as a consequence of cerebral damage. J Neurol Neurosurg Psychiatry 1974;37:241-248.

  25. Astrup T. Assay and content of tissue thromboplastin in different organs. Thromb Diath Haemorr 1965;14:401-416.

  26. Astrup T. Tissue activators of plasminogen. Ged Proc 1966;25:4251.

  27. Takashima S, Koga M, Tanaka K. Fibrinolytic activity of human brain and cerebrospinal fluid. Br J Exp Pathol 1969; 50:533-539.




2020     |     www.medigraphic.com