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February 7, 1972

Afibrinogenemia With Severe Head Trauma

JAMA. 1972;219(6):755-756. doi:10.1001/jama.1972.03190320055025

To the Editor.—  Fibrinogen levels may be variously affected by disturbances of homeostasis. Injury is usually followed by evaluation of plasma fibrinogen value.1 A decrease of modest proportions accompanies normal delivery, while abnormal parturition is associated with a more precipitous one.2 Depletion of fibrinogen of varying degrees may be seen with infection, endotoxemia, tumor, intravascular hemolysis, antigen-antibody interaction, and hypotension.3 These entities have in common the defibrinogenation of blood by its contact with thromboplastic substances or by the acceleration of fibrinolysis or by combinations of these mechanisms.Occasionally, profound reduction of fibrinogen occurs, as in an instance in which severe head trauma alone appeared responsible.

Report of a Case.—  A 13-year-old Negro girl in apparently good health until the day of admission was brought to the emergency room within one hour following a gunshot wound to the right frontal region. She was comatose, apneic, and demonstrated anisocoria.