CPP Versus PFC to Correct Coagulation Disorders in Adult Neurosurgical Patients

The coagulation disorders increase the risk of bleeding and are a risk factor of intracranial hemorrhagic complications in neurosurgical patients. They are diagnosed more often in emergency on a PT value less than 60% and so they should be corrected as soon as possible. Two therapeutic strategies are proposed by French or international recommendations: transfusion of fresh frozen plasma (FFP) or administration of prothrombin complex concentrates (PCC).

This prospective, randomized, multicenter study with blinded assessment of the primary endpoint, is performed to determine whether PCC confers any benefits over FFP in the neurological patients with coagulation disorders.

Inclusion criteria

• Patient with spontaneous intracranial hemorrhage or traumatic intracranial hemorrhage or patient requiring neurological surgery
• Coagulation disorder defined by PT less than 60%

Exclusion criteria

• Concomitant use with oral anticoagulant drugs
• Acquired deficiency of coagulation factors whose treatment is established
• Hypersensitivity to a PCC
• History of thrombocytopenia induced by heparin
• Disseminated intravascular coagulation
• Extracranial active bleeding
• Hypersensitivity to vitamin K