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Biomedical subjects

H Fodstad

Publications and source records attributed to H Fodstad.

At least 73 records · Page 4Linked to original sources
PubMed1981

Coagulation and fibrinolysis in blood and cerebrospinal fluid after aneurysmal subarachnoid haemorrhage: effect of tranexamic acid (AMCA).

Serial assays of blood coagulation factors as well as of fibrin/fibrinogen degradation products (FDP) and plasminogen activatory activity (PA) on fibrin plates in blood and cerebrospinal fluid (CSF) were performed in 41 consecutive patients with recently ruptured cerebral aneurysms, 21 of whom were randomly treated with tranexamic acid (AMCA). Coagulation factors were unaffected by the drug and plasminogen and FDP decreased in blood after two weeks' treatment. After one week, PA in CSF was increased in control patients and unchanged in AMCA-treated patients, whereas CSF-FDP had decreased among AMCA-treated patients. After two weeks PA as well as FDP in CSF showed the same values in both groups. An increase in CSF-FDP occurred after rebleeding and in patients with cerebral ischaemic symptoms. The results indicate that AMCA inhibits local fibrinolysis in CSF in patients with aneurysm rupture.

Adult↗
PubMed1981

Determination of tranexamic acid (AMCA) and fibrin/fibrinogen degradation products in cerebrospinal fluid after aneurysmal subarachnoid haemorrhage.

Six patients with recently ruptured intracranial aneurysms were treated preoperatively with tranexamic acid (AMCA). Two patients received 6 g daily in i.v. infusion, two had 6 g daily by i.v. injection, and two patients were given AMCA 9 g daily by mouth during the first week after bleeding. Serial assays of AMCA and fibrin/fibrinogen degradation products (FDP) in cerebrospinal fluid (CSF) were performed during 6--13 days after the initial subarachnoid haemorrhage (SAH). Judged from the decline in CSF-FDP, an assumed therapeutic level of greater than or equal to 1 mg/l of AMCA in CSF was reached within 24--36 hours after the first dose when the drug was administered intravenously and within 48 hours when the drug was given orally.

Adult↗
PubMed1981

Fibrinolytic activity of cerebral tissue after experimental subarachnoid haemorrhage: inhibitory effect of tranexamic acid (AMCA).

The influence of tranexamic acid (AMCA) on the fibrinolytic activity induced by plasminogen activators (PA) of the cerebral leptomeninges, arteries and choroid plexus after artificial subarachnoid haemorrhage (SAH) was studied in 90 rabbits. SAH was induced by injection of 1-2 ml autologous blood into the suboccipital cistern. Half of the rabbits were given AMCA, 200 mg per kg body weight, in daily single i.v. injections. The rabbits were sacrificed after 3-5, 8-10 and 14-15 days respectively. Part of the leptomeninges, basilar artery and choroid plexus were removed for assaying PA by the histochemical fibrin slide and fibrin plate methods, using thiocyanate for extraction of plasminogen activator from the tissues. Quantitative assays for the fibrin plate method showed high PA in the arterial and meningeal tissues from the untreated animals 3-5 days after SAH. The PA had decreased to normal levels 8-10 days after SAH but increased again 14-15 days after SAH. A lower PA in the choroid plexus followed the same pattern. The concentration of the primary plasmin inhibitor in plasma had decreased to half of the normal value 8 days after SAH when compared to the concentration in pooled plasma from normal rabbits. In AMCA treated animals the meningeal PA, assayed by both methods, was decreased 3-5 days after SAH while no or an insignificant decrease in PA was seen 8-10 and 14-15 days after SAH. The PA of the arterial vessel wall and choroid plexus in the AMCA treated animals, assayed by the histochemical method, was moderately decreased 3-5 days after SAH, while no significant differences between untreated and AMCA treated animals were seen after 8-10 or 14-15 days when the tissues were assayed by either method. These findings indicate that AMCA suppresses PA primarily in the leptomeninges during the first few days after SAH and presumably before the meningeal fibrosis has developed.

Animals↗
PubMed1981

Antifibrinolysis with tranexamic acid in aneurysmal subarachnoid hemorrhage: a consecutive controlled clinical trial.

A randomized controlled clinical trial was carried out to study the effect of tranexamic acid (AMCA, Cyklokapron; AB Kabi, Stockholm, Sweden) in the prevention of early rebleeding after the rupture of an intracranial aneurysm. The incidence of vasospasm, hydrocephalus, cerebral ischemic and thromboembolic complications, morbidity, and mortality was also evaluated. The series comprises 59 patients, 30 treated with tranexamic acid and 29 controls. The treatment was stopped if there was rebleeding, operation, or discharge from the hospital. There were 6 recurrent hemorrhages in 6 patients in the tranexamic acid-treated group and 11 recurrences in 7 patients in the control group. Recurrent hemorrhages occurred later in tranexamic acid-treated patients than in controls. Five patients in each group died from rebleeding. Five additional treated patients and 2 controls died from cerebral ischemic dysfunction. The results suggest that tranexamic acid may protect patients with ruptured aneurysms from rebleeding for 1 or 2 weeks, but that it also may produce cerebral ischemic complications.

Adult↗
PubMed1979

Spontaneous thrombosis of ruptured intracranial aneurysms during treatment with tranexamic acid (AMCA). Report of three cases.

Radiographically verified spontaneous disappearance of medium-sized arterial cerebral aneurysms is seldom reported, and only three times in connection with antifibrinolytic therapy (EACA). In our clinic repeat angiograms have shown non-filling of the aneurysms in three patients during treatment with tranexamic acid (AMCA) two, three, and four weeks respectively after primary bleeds. Initially, all three patients had severe radiological vasospasm associated with neurological deterioration. Follow-up angiograms have demonstrated partial reappearance of the aneurysm after one month in one patient and complete disappearance of the aneurysms in the other two patients after 9 and 22 months respectively. In two cases occlusion of cerebral arteries occurred. With regard to the higher risk of severe vasospasm and occlusion of cerebral arteries in our opinion it should not be a therapeutic goal to try to achieve a thrombosis of a ruptured aneurysm with antifibrinolytic drugs. The reason for spontaneous aneurysm thrombosis during treatment with AMCA may be a local inhibition of plasminogen activators in and around the aneurysm wall. It may also be related to the sympathomimetic property of the drug, with vasospasm and a subsequent flow-reduction inside the aneurysm or a possible interaction with other drugs and substances.

Adult↗
PubMed1978

Redundant nerve roots of the cauda equina. A report of five cases.

Five personally examined cases of redundant nerve roots of the cauda equina are added to the 13 hitherto on record. Except for segmental neurological deficits, intermittent claudication-like symptoms of the cauda equina dominated the histories of four of our five cases. The diagnosis was confirmed at surgical exploration, which included laminal and dural decompression. At follow-up (two months--three years) the neurological deficit, or the intermittent claudication, or both, had improved in all our patients. The pathogenesis of root redundancy is obscure. It seems that the symptoms arise through the action of at least two factors viz compression of the spinal content and the existence of one or more redundant roots. Wider use of diagnostic aids and surgical exploration would probably show that redundant roots are more common than hitherto supposed.

Aged↗
PubMed1978

Echo-encephalographic studies in patients with space-occupying lesions in the posterior fossa.

Echo-encephalographic studies were performed on 57 patients treated for space-occupying lesions in the posterior fossa. Preoperative echo-ventriculography (EVG) on 36 patients showed that 32 (89%) had dilatation of the third ventricle. Three of the four patients with normal preoperative ventricle width had cerebello-pontine angle tumors. Papilledema was lacking in many cases with considerable ventricular dilatation on EVG. Postoperative examinations on 49 patients showed in most cases a fairly rapid normalization of ventricular size often already during the first 1-4 weeks after operation. Postoperative EVG monitoring of the ventricular system was particularly useful for detection of shunt dysfunctions and recurrence of tumors. Computerized tomography have to some extent replaced echo-encephalography, but it is concluded that EVG still offers some definite advantages for certain application in the management of patients with posterior fossa lesions.

Adolescent↗
PubMed1978

Giant serpentine intracranial aneurysm after carotid ligation. Case report.

A case is reported of a giant aneursym of the intracavernous portion of the left internal carotid artery that was treated initially with a left common carotid artery ligation. Six months later the aneurysm was partially removed. During this time the development and evolution of thrombus formation, a serpentine channel, and a hypervascular capsule was easily followed with recreated computerized tomography and angiography of the aneurysm.

Adult↗
PubMed1978

Tranexamic acid in the preoperative management of ruptured intracranial aneurysms.

A randomized, controlled clinical trial was carried out to study the effect of tranexamic acid (AMCA, trans-AMCHA) in prevention of early rebleeding after proven rupture of an intracranial aneurysm. The series comprises 46 patients admitted to the hospital within three days after the first bleeding. Twenty-three were treated with tranexamic acid and 23 were controls. Nine patients in the control group and one in the group treated with tranexamic acid had confirmed rebleeding. The incidence of vasospasm, cerebral ischemia and hydrocephalus as well as mortality and morbidity is discussed.

Adult↗
PubMed1977

Fibrinolytic activity in the walls of cerebral saccular aneurysms.

The fibrinolytic activity of 28 cerebral saccular aneurysms from 24 patients and of controls consisting of 10 cerebral arteries has been studied by Todd's autography technique. An increased activity was seen in the minute adventitial vessels and in the endothelium in ruptured cerebral saccular aneurysms, but the aneurysms showed somewhat less activity than the surrounding arteries. Seven patients with subarachnoid haemorrhage had the same increase in fibrinolytic activity in the aneurysmal wall despite antifibrinolytic therapy ante mortem. This finding has been discussed.

Adult↗