Experiences with epsilon-aminocaproic acid in neurosurgery. (A preliminary report).

Abstract

The favourable effect of epsilon-aminocaproic acid (E-ACA) on abnormal fibrinolytic conditions in various extracranial diseases and surgical interventions is well-known, but, so far, data on E-ACA in neurosurgery have not been published. Preliminary beneficial experiences with E-ACA, for controlling diffuse and extensive bleeding episodes in certain neurosurgical operations are reported. Two cases of intracranial arterio-venous malformations are referred to. During the removal of these angiomas, bleeding from the surgical bed could not be efficiently attacked with ordinary neurosurgical haemostatic technique (diathermy, haemostatic materials, etc.). After intravenous administration of E-ACA sufficient haemostasis was promptly achieved. A possible mechanism of an abnormally increased fibrinolytic activity released locally in the operative field is considered. It is recommended that E-ACA might be tried in those neurosurgical operations where local bleeding sometimes offers intricate problems, i. e. the arterio-venous malformations and the meningiomas.