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Published on: August 18, 2015
Thrombocytosis in the NICU.
David J Powner1, W Keith Hoots
1Department of Neurosurgery, Vivian L. Smith Center for Neurologic Research, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 7.154, Houston, TX 77030, USA. david.j.powner@uth.tmc.edu
Neurocritical Care
|March 22, 2008
Summary
Elevated platelet counts in neurosurgery patients are often secondary thrombocytosis from inflammation or infection. Low-dose aspirin may suffice if treatment is needed, but thrombosis risk requires assessment.
Area of Science:
- Neurology
- Neurosurgery
- Hematology
Background:
- Elevated platelet counts (thrombocytosis) are common in neurology/neurosurgery patients.
- This is typically reactive or secondary thrombocytosis (ST) linked to inflammation or infection.
- Primary thrombocythemia (essential thrombocythemia) from myeloproliferative disorders is less common and usually diagnosed earlier.
Purpose of the Study:
- To differentiate causes of thrombocytosis in neurosurgery patients.
- To identify diagnostic markers for secondary thrombocytosis.
- To guide management and risk assessment for thromboembolism.
Main Methods:
- Review of clinical presentations and laboratory findings in neurology/neurosurgery patients with elevated platelet counts.
- Analysis of diagnostic markers for differentiating primary from secondary thrombocytosis.
- Evaluation of thrombosis risk and treatment strategies for ST.
Main Results:
- Secondary thrombocytosis is the usual cause of elevated platelets in this population.
- Acute phase reactants (e.g., C-reactive protein, IL-6) can aid in diagnosing ST.
- Thrombosis is rare in ST, but ST should inform overall thromboembolism risk assessment.
- Low-dose aspirin is often sufficient for management.
Conclusions:
- Secondary thrombocytosis is common in neurosurgery patients, often due to inflammation or infection.
- Diagnostic tests for acute phase responses can help identify ST.
- While thrombosis is rare, ST necessitates careful thromboembolism risk assessment and management, potentially with low-dose aspirin.
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