Coagulation Study in Patients Who Had Undergone Surgery for Meningioma

Abstract

Abnormal fibrinolysis and thrombotic complications have been often observed in patients who had undergone surgery for meningioma. Fourteen patients, affected by meningioma, were studied before surgery, during surgery and 24 h after surgery in order to evaluate the modifications of the fibrinolysis system and the coagulation physiological inhibitors. Before surgery, no patient showed hyperfibrinolysis and/or modifications of coagulation physiological inhibitors. During surgery, an activation of fibrinolysis with pathological levels of tissue plasminogen activator activity (x = 6.33 U/dl, SD = 7.9, p = 0.02) and increased levels of fibrin degradation products (x = 0.21, SD = 0.18, p = 0.002) was noted. Modifications of the fibrinolysis parameters occurred only in 9/14 patients (64%). These patients presented a more vascularized tumour, revealed before surgery by computerized tomography scan and cerebral arteriography and directly confirmed during the resection. Twenty-four hours after surgery no patient presented fibrinolysis activation. There was no evidence of disseminated intravascular coagulation in our patients. None of them presented pathological decrease of the physiological coagulation inhibitors or thrombotic complications. In conclusion, during surgery, fibrinolysis parameters show important modifications in patients with vascularized meningioma suggesting an ongoing tumour-host interaction. These variations must be taken in account, in order to plan timely a correct therapeutic approach.

Critically Ill Cancer Patients are not Consistently Hypercoagulable after Craniotomy

“…Other authors have reported similar findings in adults as well as in children [23][24][25]. This fibrinolysis syndrome noted by so many authors, and with a reported incidence of 64% by Dragoni et al [26], was not evident in our TEG results of up to 1 h long analysis.…”

The effect of antiepileptic drugs on coagulation and bleeding in the perioperative period of epilepsy surgery: The Cleveland Clinic experience

“…21 Brain tumor surgery, in particular meningioma resection, is associated with activation of the fibrinolytic system. 22 The third important finding is the large percentage of patients who receive transfusions of blood products intraoperatively or immediately after surgery. Along with orthopedic procedures, neurosurgical interventions are the most common cause for perioperative blood transfusion in children.…”