Q: Tranexamic acid is another very useful drug to improve long-term functional outcomes if given early in hyperacute primary Intra Cerebral Hemorrhage (ICH).
Tranexamic acid works via inhibiting fibrinolysis and the proteolytic activity of plasmin. Unfortunately, it failed to show any utility in hyperacute primary ICH. It failed to show any difference in 90-day functional status or mortality.
Said that it has shown some favor towards early reductions in hematoma growth and early death.
1. Sprigg N, Flaherty K, Appleton JP, et al. Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet 2018; 391:2107.
2. Meretoja A, Yassi N, Wu TY, et al. Tranexamic acid in patients with intracerebral haemorrhage (STOP-AUST): a multicentre, randomised, placebo-controlled, phase 2 trial. Lancet Neurol 2020; 19:980.