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Updated: Jan 21, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Thromboelastometry as a Comprehensive Assessment of Hypercoagulation After Aneurysmal Subarachnoid Hemorrhage: A Case

Anastasia I Baranich1, Aleksandr A Polupan2, Aleksandr A Sychev2

  • 1Department of Neurocritical Care, N.N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia. anastasia.baranich@gmail.com.

Acta Neurochirurgica. Supplement
|August 14, 2019
PubMed

Subarachnoid hemorrhage after cerebral aneurysm rupture (aSAH) leads to delayed cerebral ischemia (DCI) in 25-35% of surviving patients. It is believed that DCI has a multifactorial etiology, including vasospasm. Furthermore, aSAH is associated with the development of hypercoagulation and microthrombosis; thus, its pharmacological correction may help to prevent DCI. We encountered a case where hypercoagulation was detected using rotational thromboelastometry (ROTEM), although the standard coagulation test results were within the normal ranges. Based on reviews of viscoelastic tests in cases of aSAH, ROTEM could be more sensitive to hypercoagulation after aSAH, compared to standard coagulation testing.

Keywords:
Delayed cerebral ischemiaMicrothrombosisSecondary brain injurySubarachnoid hemorrhage

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