Abstract In the mid 1960s, Mullan and Dawley,1 in the course of experimental work, noted that electrically induced thrombi in the femoral artery of dogs, which were normally of short duration, could be made to last longer when the antifibrinolytic agent ∈-aminocaproic acid was administered. This observation induced them to use the same agent in an attempt to prevent recurrent hemorrhage in patients who had recently suffered subarachnoid hemorrhage from ruptured aneurysms. In 1965, Norlén and Thulin2 had found the same agent to be of value during the surgery on two cases of arteriovenous malformations. This also had led them to employ antifibrinolytic agents in the management of ruptured saccular aneurysms, virtually simultaneously with Mullan and Dawley. The reasoning in both investigations was similar. If the dissolution of the hemostatic clot at the site of rupture could be delayed, the definitive operative procedure for the repair of the References 1. Mullan S, Dawley J: Antifibrinolytic therapy for intracranial aneurysms . J Neurosurg 1968;28:21-23.Crossref 2. Norlén G, Thulin CA: The use of antifibrinolytic substances in ruptured intracranial aneurysms . Neurochirurgia 1969;12:100-102. 3. Nibbelink DW, Torner JC, Henderson WG: Intracranial aneurysms and subarachnoid hemorrhage: A cooperative study: Antifibrinolytic therapy in recent onset subarachnoid hemorrhage . Stroke 1975;6:622-629.Crossref 4. Adams HP Jr, Nibbelink DW, Torner JC, et al: Antifibrinolytic therapy in patients with aneurysmal subarachnoid hemorrhage: A report of the coopeative aneurysm study . Arch Neurol 1981;38:25-29.Crossref 5. Ramirez-Lassepas M: Antifibrinolytic therapy in subarachnoid hemorrhage caused by ruptured intracranial aneurysm . Neurology 1981;31:316-322.Crossref 6. Fodstad H: Antifibrinolytic treatment in subarachnoid hemorrhage: Present state . Acta Neurochir 1982;63:233-244.Crossref 7. Béguelin C, Seiler R: Subarachnoid hemorrhage with normal cerebral panangiography . Neurosurgery 1983;13:409-411.Crossref 8. Kassell NF, Torner JC, Adams HP Jr: Antifibrinolytic therapy in the acute period following aneurysmal subarachnoid hemorrhage: Preliminary observations from the cooperative aneurysm study . J Neurosurg 1984;61:225-230.Crossref 9. Vermeulen M, Lindsay KW, Murray GD, et al: Antifibrinolytic treatment in subarachnoid hemorrhage . N Engl J Med 1984;311:432-437.Crossref 10. Adams HP Jr, Nibbelink DW, Torner JC, et al: Antifibrinolytic therapy in patients with aneurysmal subarachnoid hemorrhage , in Sahs AL, Nibbelink DW, Torner JC (eds): Aneurysmal Subarachnoid Hemorrhage: Report of the Cooperative Study . Baltimore, Urban & Schwarzen-berg, 1981, pp 331-339.
Archives of Neurology – American Medical Association
Published: Jan 1, 1987
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