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Hemostasis activation in patients undergoing brain tumor surgery
T C Vukovich1, A Gabriel, B Schaefer
1Department of Laboratory Medicine, University Hospital of Vienna, Vienna, Austria. mario.veitl@univie.ac.at.
Neurosurgical Focus
|April 15, 1997
Summary
D-dimer levels significantly increase during brain tumor surgery for glioma and meningioma, indicating a higher thromboembolism risk. This marker can help estimate risk in neurosurgery patients.
Area of Science:
- Neurosurgery
- Hematology
- Oncology
Background:
- Patients undergoing brain tumor surgery face a high risk of thromboembolic events.
- Routine coagulation parameters are often unreliable for risk stratification in this population.
Purpose of the Study:
- To evaluate D-dimer as a specific hemostasis activation marker for estimating thromboembolism risk in neurosurgery patients.
- To analyze the perioperative time pattern of D-dimer and routine coagulation parameters in patients with glioma, meningioma, and metastases.
Main Methods:
- Prospective study of 28 neurosurgery patients categorized by thromboembolism risk (high: glioma, meningioma; low: metastases).
- Serial measurements of routine coagulation parameters and D-dimer during the perioperative period (preoperative, intraoperative, postoperative Days 2 and 7).
Main Results:
- Routine coagulation parameters showed non-specific changes due to hemodilution and acute-phase reactions.
- D-dimer levels were baseline elevated in metastases patients (cancer-associated hyperactivity).
- Marked D-dimer increase during surgery in glioma/meningioma patients, remaining elevated postoperatively, unlike metastases patients.
Conclusions:
- Perioperative D-dimer levels correlate with the thromboembolic risk in patients with glioma and meningioma.
- D-dimer shows potential as a valuable laboratory marker for individual risk estimation in neurosurgery.
- Further evaluation of D-dimer for monitoring prophylactic treatment efficacy is warranted.