• Jorge Kawano-Castillo, Eric Ward, Andrea Elliott, Jeremy Wetzel, Amanda Hassler, Mark McDonald, Stephanie A Parker, Joancy Archeval-Lao, Chad Tremont, Chunyan Cai, Evan Pivalizza, Mohammad H Rahbar, and James C Grotta.
• From the Department of Neurology, The University of Texas Medical School, Houston (J.K.-C., E.W., A.E., J.W., A.H., M.M., S.A.P., J.A.-L., C.T., E.P., J.C.G.); and Center for Clinical and Translational Sciences, University of Texas at Houston (C.C., M.H.R.).
• Stroke. 2014 Mar 1;45(3):683-8.

Background And PurposeIntracerebral hemorrhage (ICH) has high morbidity, and hematoma enlargement (HE) causes worse outcome. Thrombelastography (TEG) measures the dynamics of clot formation and dissolution, and might be useful for assessing bleeding risk. We used TEG to detect changes in clotting in patients with and without HE after ICH.MethodsThis prospective study included 64 patients with spontaneous ICH admitted from 2009 to 2013. TEG was performed within 6 hours of symptom onset and after 36 hours. Brain imaging was obtained at baseline and at 36±12 hours, and HE was defined as total volume increase>6 cc or >33%. TEG was also obtained from 57 controls.ResultsCompared with controls, patients with ICH demonstrated faster and stronger clot formation; shorter R and delta (P<0.0001) at baseline; and higher MA and G (P<0.0001) at 36 hours; 11 patients had HE. After controlling for potential confounders, baseline K and delta were longer in HE+ compared with HE- patients, indicating that HE+ patients had slower clot formation (P<0.05). TEG was not different between HE+ and HE- patients at 36 hours.ConclusionsTEG may detect important coagulation changes in patients with ICH. Clotting may be faster and stronger in immediate response to ICH, and a less robust response may be associated with HE. These findings deserve further investigation.

29 keywords...

hide…