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Acta Neurochir (Wien) ; 152(3): 529-32, 2010 Mar.
Article in English | MEDLINE | ID: mdl-19557304

ABSTRACT

BACKGROUND: Postoperative intracranial haemorrhage can be a dramatic event, carrying significant morbidity and mortality. Bleeding at sites remote from the operation area represents a small percentage of haemorrhages whose aetiology remains unclear (Harders et al. Acta Neurochir (Wien) 74(1-2):57-60, 1985). AIM: We present the case of a 60-year-old patient who underwent posterior fossa craniotomy for the removal of a space-occupying lesion and suffered supratentorial haemorrhage soon after the operation. RESULTS: A thorough postoperative investigation revealed low levels of factor XIII (FXIII), the factor mainly responsible for fibrin clot stabilisation. CONCLUSION: We suggest that reduced FXIII activity may be an important but preventable predisposing factor to remote postoperative haemorrhage in neurosurgical patients.


Subject(s)
Cerebellum/surgery , Cranial Fossa, Posterior/surgery , Cysts/surgery , Factor XIII Deficiency/complications , Neurosurgical Procedures/adverse effects , Postoperative Hemorrhage/etiology , Blood Coagulation/physiology , Brain/blood supply , Brain/diagnostic imaging , Brain/pathology , Cerebellum/pathology , Cerebral Angiography , Cerebral Arteries/diagnostic imaging , Cerebral Arteries/pathology , Cerebral Arteries/physiopathology , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/pathology , Cerebral Hemorrhage/physiopathology , Coma/etiology , Cysts/pathology , Decompression, Surgical , Factor XIII Deficiency/genetics , Factor XIII Deficiency/metabolism , Female , Hernia/diagnostic imaging , Hernia/etiology , Hernia/pathology , Humans , Hydrocephalus/etiology , Hydrocephalus/pathology , Hydrocephalus/physiopathology , Intracranial Hypertension/epidemiology , Intracranial Hypertension/pathology , Intracranial Hypertension/physiopathology , Magnetic Resonance Imaging , Middle Aged , Postoperative Hemorrhage/pathology , Postoperative Hemorrhage/physiopathology , Time , Tomography, X-Ray Computed , Treatment Outcome
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