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Master Thesis

Fonction plaquettaire et altération de l’hémostase après hémorragie sous arachnoïdienne

Abstract : Context: vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH) remain incompletely understood. Platelet activation and alterations in hemostasis might lead to vasospasm and Delayed Cerebral Ischemia (DCI). We investigated platelet function and hemostasis in aSAH patients over time and compared platelet function of patients with and without DCI. We detailed also platelet functions in SAH patients in comparison with the platelet functional profile obtained in patients having an acute inflammation related to orthopedic surgery. Methods : blood samples were studied after aSAH onset (day 5) and then during period at risk of vasospasm (day 10) for the expression of GpIIbIIIa and P-selectin as well as the aggregation rate in the presence of agonists. Endothelium function was evaluated with plasma factor VIII and von Willebrand. Results : 12 high grade aSAH with coiling aneurysm were include and 6 patients in Postop group. aSAH platelets were activated and remained activated over time, especially on the ADP pathway. Plasma factors increased with DCI, demonstrating a propensity towards endothelial activation. Platelets of SAH and Postop patients were similarly activated.Conclusions: aSAH patients showed severe alterations of platelet function and hemostasis that may play a role in the risk of clotting and ischemia. Some of the hemostasis alterations may be potential biomarkers that can be used to detect vasospasm.
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Master Thesis
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Pauline Perez. Fonction plaquettaire et altération de l’hémostase après hémorragie sous arachnoïdienne. Médecine humaine et pathologie. 2017. ⟨dumas-01781357⟩

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