Randomized Control Trial Study of Role of Tranexamic Acid in Prevention of Re- Bleeding in Rupture Aneurysmal Patient Before Aneurysmal Surgical Treatment.

One of the major causes of mortality and morbidity in aSAH patients is recurrent bleeding. The highest risk of rebleeding occurs within the first 3 days. It usually occurs within 24 hours. Early studies suggested iv TXA in aSAH patients reduced the incidence of recurrent bleeding as well as probably functional outcome, but increased complications such as delayed cerebral ischemia and thromboembolic events.Patients with aSAH were randomly divided into two groups; the control group and patients receiving standard treatment with the addition of receiving TXA. TXAwas given 1 gm bonus IV, followed by 1 gm IV every 8 hours for the next 72 hours. The outcome was measured in terms of bleeding, side effects, and functional outcome.Atotal of 149 cases of SAH were enrolled in the study. Of those, 38.9% received TXAand the rest (61.1%) received standard treatment. In the TXAgroup re-bleeding was seen in 5.2% of cases, delayed cerebral ischemia was seen in 17.2% of cases, and hospital mortality in 3.4% of cases, significantly lower as compared to the non-TXA group, and favourable outcome (3 months) MRS in 74.1% of cases showed significant improvement in the TXAgroup.The study suggested short-term use (72 hours) of Iv TXAsignificantly decreased re-bleeding in aSAH patients. there was also a reduction in hospital mortality and improved functional outcome without increased complications like delayed cerebral ischemia, thromboembolic events, or hydrocephalus.