Thromboelastometry as a Comprehensive Assessment of Hypercoagulation After Aneurysmal Subarachnoid Hemorrhage: A Case Report and Literature Review

  • Anastasia I. BaranichEmail author
  • Aleksandr A. Polupan
  • Aleksandr A. Sychev
  • Ivan A. Savin
  • Togrul F. Tabasaranskiy
  • Natalia V. Kurdumova
  • Shalva Sh. Eliava
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 127)


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.


Subarachnoid hemorrhage Microthrombosis Delayed cerebral ischemia Secondary brain injury 


Conflict of Interest

The authors declare no conflicts of interest.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Anastasia I. Baranich
    • 1
    Email author
  • Aleksandr A. Polupan
    • 1
  • Aleksandr A. Sychev
    • 1
  • Ivan A. Savin
    • 1
  • Togrul F. Tabasaranskiy
    • 1
  • Natalia V. Kurdumova
    • 1
  • Shalva Sh. Eliava
    • 1
  1. 1.Department of Neurocritical CareN.N. Burdenko National Scientific and Practical Center for NeurosurgeryMoscowRussia

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