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[Studies on the fibrinolytic system in ruptured intracranial aneurysm. Part 1. Monitoring of the antifibrinolytic therapy through repeated measurement of SK-euglobulin lysis time and FDP (author's transl)].

Streptokinase euglobulin lysis time (SK-ELK), fibrin and fibrinogen degradation products (FDP) and fibrinogen in the blood were determined to know the proper dosage of t-AMCHA which would not cause the ischemic complications yet suffice to prevent the rebleeding of ruptured intracranial aneurysm. SK-ELT was almost doubled(130 sec) by the administration of 6-8g/day of t-AMCHA within 24-48h in normal control. On the other hand, SK-ELT in SAH patients fluctuated tremendously during ten days after the first bleeding. FDP took a high value soon after the first bleeding in grade IV and V patients. Increase in FDP was also observed following rebleeding in one case, following severe vasospasm, and following progressive neurological deterioration, and the increase in FDP was concentrated 4-10 days after SAH. Fibrinogen showed a tendency to increase gradually after the administration of t-AMCHA, and this increase of fibrinogen would be one of the alarming signs of the development of ischemic complications. From these results, it was suggested that the dosis of t-AMCHA should be determined precisely according to the result of repeated monitoring, and the dosis should be as such that it could constantly keep SK-ELT at 130-150 sec.