A Clinical Study of FDP Value in Patients with Altered Consciousness.
- Author:
Young Beag KIM
1
;
Jong Sik SUK
Author Information
1. Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
Blood Coagulation;
Brain;
Brain Injuries;
Brain Stem;
Cerebral Hemorrhage;
Consciousness*;
Contusions;
Craniocerebral Trauma;
Disseminated Intravascular Coagulation;
Fibrinogen;
Head Injuries, Closed;
Hematoma;
Hemorrhage;
Humans;
Partial Thromboplastin Time;
Plasma;
Prothrombin Time;
Thromboplastin
- From:Journal of Korean Neurosurgical Society
1982;11(4):453-462
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Recent reports have proved that the activity of blood coagulation change in the patients with head injury because of destruction of brain tissue. To evaluate the relationship of the activity of blood coagulation with patient's consciousness level, clinical course, neurological deficit and findings of computed tomography of brain in the patients with head injury and cerebrovascular disease. Coagulation studies(fibrin/fibrinogen degradation product concentration, plasma fibrinogen, prothrombin time, and activated partial thromboplastin time) and computed tomography of brain were in 102 patients with altered consciousness(66 patients of blunt head injury, 36 patients of cerebrovascular disease). Blood specimen were taken for coagulation studies within 24 hours after head injury or attack of cerebrovascular disease because of that, in the first 24 hours after brain injury, activated coagulation was present after injury. Statistical methods employed were Spearman's rank correlation coefficient and Chi-square test. The results were as follows : 1) Among 66 patients of head injury, 26 patients showed abnormal coagulation results(39%). The one patient of them showed increased FDP value, decreased fibrinogen, abnormal prothrobin time and activated partial thromboplastin time, clinically suggested disseminated intravascular coagulation, and remainder of them(25 patients, 37.9%) revealed abnormality only in FDP value. 2) In patients with head injury, the value of FDP had a close relationship with the state of consciousness on admission, the patient's clinical course, and neurological deficits(P<0.005). 3) In patients with head injury, the value of FDP was proportional to the degree of contusion and midline shift shown on computed tomography of brain(P<0.005). 4) It was concluded that some degree of disseminated intravascular coagulation in patients with blunt head injury occurs more often than expected clinically or subclinically and that coagulation studies might have both diagnostic and prognotic values. 5) In patients with cerebrovascular disease, the value of FDP was abnormal in 19.4% only in intracerebral hemorrhage and normal in other cases(other coagulation tests were normal in all cases). 6) In cases of intracerebral hemorrhage, the value of FDP had a meaningful correlation with amount of hematoma and degree of brain stem dsyfunction, but not with other findings. 7) In cases of intracerebral hemorrhage, the clinical course correlated with the site of hemorrhage and it's extension rather than the amount of brain destruction.
