Baranich Anastasia I, Polupan Aleksandr A, Sychev Aleksandr A, Savin Ivan A, Tabasaranskiy Togrul F, Kurdumova Natalia V, Eliava Shalva Sh
Department of Neurocritical Care, N.N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia.
Acta Neurochir Suppl. 2020;127:165-169. doi: 10.1007/978-3-030-04615-6_25.
Subarachnoid hemorrhage after cerebral aneurysm rupture (aSAH) leads to delayed cerebral ischemia (DCI) in 25-35% of surviving patients. It is believed that DCI has a multifactorial etiology, including vasospasm. Furthermore, aSAH is associated with the development of hypercoagulation and microthrombosis; thus, its pharmacological correction may help to prevent DCI. We encountered a case where hypercoagulation was detected using rotational thromboelastometry (ROTEM), although the standard coagulation test results were within the normal ranges. Based on reviews of viscoelastic tests in cases of aSAH, ROTEM could be more sensitive to hypercoagulation after aSAH, compared to standard coagulation testing.
脑动脉瘤破裂后蛛网膜下腔出血（aSAH）会导致25%至35%的存活患者发生迟发性脑缺血（DCI）。据信，DCI病因是多因素的，包括血管痉挛。此外，aSAH与高凝状态和微血栓形成的发展有关；因此，对其进行药物纠正可能有助于预防DCI。我们遇到了一个病例，尽管标准凝血试验结果在正常范围内，但使用旋转血栓弹力图（ROTEM）检测到了高凝状态。基于对aSAH病例中粘弹性试验的综述，与标准凝血试验相比，ROTEM对aSAH后的高凝状态可能更敏感。
