The authors analyzed in their study changes of some markers of the haemocoagulation activity (fibrinogen, prothrombin time, partial thromboplastin time, platelet factors 3 and 4 - DF3, DF4) in the early stage of an ischaemic cerebrovascular attack (CVA). In a group of 22 patients they found a statistically significant decline of the DF4 activity already during the first 24 hours as compared with the control group, on the 7th day they recorded a further decline of activity of this factor (p = 0.05). Changes in DF3 activity and fibrinogen were not statistically significant. After dividing the group into sub-groups with a high and low risk of cardioembolism (in relation to the assumed cardiac embolism as the cause of CVA) the authors found in the sub-group of 14 patients (63.6 %) with a low risk of cardioembolism (an atherothrombotic process was assumed) a lower mean fibrinogen level (2.94 g/l) and a decline of DF4 activity in the acute stage of the CVA. In the sub-group of 8 patients (36.4 %) with a high risk of cardiac embolism into the CNS (assumed cardioembolic mechanism of CVA) the authors recorded an elevated mean fibrinogen level (3.82 g/l). They also found a decline of DF4 ac tivity already during the first day with a further drop of activity on the 7th day (these changes were not statistically significant). The authors assume that the different fibrinogen levels in the sub-groups of patients with a low and high risk of cardiac embolization could reflect a different activation of coagulation, assuming a different pathogenetic mechanism of CVA (atherothrombotic and cardioembolic). Changes of DF4 activity were similar in both sub-groups of patients. The assessed abnormalities of haemocoagulation indicate that these coagulation factors reflect probably not identical but complementary mechanisms of the activated thrombotic process in the acute stage of a CVA.

        Key words: ischaemic cerebrovascular attack, haemocoagulation, fibrinogen, platelet factor 3, platelet