Tubbs R R, Benjamin S P, Dohn D E
J Neurosurg. 1979 Jul;51(1):94-7. doi: 10.3171/jns.1979.51.1.0094.
Epsilon aminocaproic acid (EACA) has been used to prevent rebleeding in patients with subarachnoid hemorrhage (SAH). Although this agent does decrease the frequency of rebleeding, several reports have described thrombotic complications of EACA therapy. These complications have included clinical deterioration and intracranial vascular thrombosis in patients with SAH, arteriolar and capillary fibrin thrombi in patients with fibrinolytic syndromes treated with EACA, or other thromboembolic phenomena. Since intravascular fibrin thrombi are often observed in patients with fibrinolytic disorders, EACA should not be implicated in the pathogenesis of fibrin thrombi in patients with disseminated intravascular coagulation or other "consumption coagulopathies." This report describes subtotal infarction of the kidney due to thrombosis of a normal renal artery. This occlusion occurred after EACA therapy in a patient with SAH and histopathological documentation of recurrent SAH. The corresponding clinical event was characterized by marked hypertension and abrupt neurological deterioration.
ε-氨基己酸（EACA）已被用于预防蛛网膜下腔出血（SAH）患者再次出血。尽管该药物确实降低了再出血的频率，但有几份报告描述了EACA治疗的血栓形成并发症。这些并发症包括SAH患者的临床恶化和颅内血管血栓形成、接受EACA治疗的纤维蛋白溶解综合征患者的小动脉和毛细血管纤维蛋白血栓，或其他血栓栓塞现象。由于在纤维蛋白溶解障碍患者中经常观察到血管内纤维蛋白血栓，EACA不应与弥散性血管内凝血或其他“消耗性凝血病”患者纤维蛋白血栓的发病机制相关。本报告描述了一名SAH患者在接受EACA治疗后，因正常肾动脉血栓形成导致的肾次全梗死，且有复发性SAH的组织病理学记录。相应的临床事件表现为明显的高血压和突然的神经功能恶化。
