Disseminated intravascular coagulation and the neuroradiologist.
نویسندگان
چکیده
The preceding article by Boyko et al. [1] is a timely reminder of the frequency with which clinicians see disseminated intravascular coagulation (DIC) in association with head trauma. DIC itself is a hematologic abnormality that results from a pathologic activation of the blood-clotting enzymes. The process may be initiated by a variety of causes, including trauma, infection, obstetric accidents, stroke, and shock. Nevertheless, the end result is the same: intravascular clotting with simultaneous consumption of clotting factors (including fibrinogen) and diffuse intravascular fibrinolysis. The last component contributes to impaired hemostasis and spontaneous hemorrhage. DIC occurs in 30-56% of patients who have head trauma [2-4], and its presence is a significant risk factor for death [3]. The unusual feature of the case reported by Boyko et al., however, is the isodense nature of an acute subdural hematoma seen on head CT only with contrast enhancement. Such an isodense, or liquid, hematoma would require the almost total absence of clot. In our experience, this state of affairs is uncommon in DIC, but could indicate active or recurrent hemorrhage [4]. More probably, the patient described had an unusually severe consumption of his fibrinogen (the level was <1 0 mgjdl) or underlying hypofibrinogenemia from liver disease, or both. Nonetheless, the authors' use of contrast
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Plasma Fibrinogen and D-dimer in Children With Sepsis: A Single-center Experience
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Disseminated intravascular coagulation.
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BACKGROUND The aims of the present study were to confirm the consumption coagulopathy of disseminated intravascular coagulation with the fibrinolytic phenotype at an early phase of trauma and to test the hypothesis that thrombin-activatable fibrinolysis inhibitor, neutrophil elastase, and plasmin contribute to the increased fibrinolysis of this type of disseminated intravascular coagulation. Fu...
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عنوان ژورنال:
- AJNR. American journal of neuroradiology
دوره 12 2 شماره
صفحات -
تاریخ انتشار 1991