HEMOSTASIS AND FIBRINOLYSIS AFTER RECENT STROKE

Several measures of haemostasis and fibrinolysis were tested in 34 patients with cerebral haemorrhage and 47 patients with cerebral infarction within 11 days of the event. No significant differences were found between the two groups, but in comparison with a control group the following values were significantly elevated as the result of coagulation and fibrinolysis: fibrin monomers, thrombin-antithrombin-III, D-dimers and tissue plasminogen activator activity. In approximately 11 % of the patients the fibrin monomer levels were elevated to such an extent (> 30 mmol/l) that they were compatible with activation of the coagulation system. It is not possible to differentiate between cerebral infarction and cerebral haemorrhage by means of coagulation or fibrinolysis parameters. In the fibrin-monomer-negative group 22 % of the patients died, compared with 5 6 % in the fibrin-monomer-positive group. Thus a state of hypercoagulability may have a negative effect on prognosis. Follow-up of 4 patients with cerebral haemorrhage showed that the abnormalities of coagulation and fibrinolysis parameters could last as long as 4 weeks.