, Volume 1, Issue 1, pp 47-51

Treatment of acute intracerebral hemorrhage with ɛ-aminocaproic acid

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Introduction: Up to 40% of primary intracerebral hemorrhages (ICHs) expand within the first 24 hours (natural history). The authors aimed to study the safety and preliminary efficacy of ɛ-aminocaproic acid (EACA) in halting ICH enlargement.

Methods: Consecutive patients with hematoma volumes ranging from 5 to 80 mL were recruited within 12 hours of ICH onset. A total of 5 g EACA was infused during 1 hour and then 1 g/hour for 23 hours. Hematoma volume was compared onbaseline, and 24–48-hour brain imaging. Consecutive untreated patients underwent the same imaging protocol.

Results: Three of the first five patients treated had HE>33% of their baseline volume. HE occurred in two of the nine untreated patients. The 80% confidence interval for HE in the treated patients was 32–88%. No thrombotic or other serious adverse events were attributed to EACA.

Conclusion: It is unlikely that the rate of HE in patients given EACA within 12 hours of ICH is less than the natural history rate, although this treatment appears to be safe.