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January 1987

Antifibrinolytics in Aneurysmal Subarachnoid Hemorrhage: Do They Have a Role? Maybe

Author Affiliations

From the Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa, Iowa City.

Arch Neurol. 1987;44(1):114-115. doi:10.1001/archneur.1987.00520130088024

Recurrent bleeding is a major, largely fatal, complication occurring primarily during the first two weeks after aneurysmal subarachnoid hemorrhage (SAH). Among patients who were initially in good condition, rebleeding is the leading cause of death after SAH.1 The prognosis of an alert patient who has a second hemorrhage declines to that of a patient who is comatose after a single SAH.2 Approximately two thirds of the patients who have rebleeding die. Rebleeding occurs within two weeks of SAH in 20% of patients.3 It peaks during the first 24 hours of SAH, when it reaches 8% to 10%.4 In the next ten days, this complication occurs at a daily rate of approximately 2%.3 For the remainder of the first month after SAH, recurrent hemorrhage occurs at a rate of 0.5% per day.3

There is no specific treatment to reverse the effects of rebleeding; prevention

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