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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Effect of heparin on secondary brain injury in subarachnoid hemorrhage

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  • Sae-Yeon Won - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany
  • Markus Bruder - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany
  • Sepide Kashefiolasl - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany
  • Nina Brawanski - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany
  • Volker Seifert - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany
  • Jürgen Konczalla - Klinik für Neurochirurgie, Goethe-Universität, Frankfurt am Main, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.06.08

doi: 10.3205/16dgnc274, urn:nbn:de:0183-16dgnc2748

Published: June 8, 2016

© 2016 Won et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Cerebral vasospasm (CVS) and delayed cerebral infarctions (DCI) after aneurysmal subarachnoid hemorrhage (SAH) are associated with poor neurological outcome. Besides the anticoagulatory effect, heparin is suspected to influence SAH associated DCI, implicating a possible treatment option. Since many patients received heparin after endovascular aneurysm treatment, we examined the influence of heparin on CVS and DCI in these patients.

Method: We performed a retrospective analysis of our since 1999 prospective maintained database. We identified 112 patients treated with heparin (PTT: 50-60s) for 24h up to 7days after endovascular treatment (H-group). The incidence and severity of vasospasm and DCI were analyzed.

Results: Patients with or without heparin did not differ in sex, age or admission status. The incidence of perfusion relevant vasospasm in patients without heparin after endovascular treatment was 41.5% compared to 33.4% in the H-group (p=0.06). This tendency was even stronger when heparin was administered for more than 24 hours, but did not reach significant levels due to small number of patients. However, there was no significant difference between H- and control-group in DCI rate and outcome.

Conclusions: The present data showed a tendency towards a beneficial effect of heparin treatment on CVS in patients suffering from aneurysmal SAH. Nevertheless, careful evaluation of the impact of heparin on SAH treatment course, CVS rate, hemorrhagic complications and clinical outcome is mandatory.