Perioperative Haemostatic Management in a Patient Undergoing Craniotomy for Excision of Meningioma: Role of Thromboelastography
Journal Title: Journal of Advanced Research in Medicine - Year 2018, Vol 5, Issue 3
Abstract
Although there is a general predisposition towards hyper-coagulability during brain tumour surgery, hypocoagulability may exist in certain cases even before surgery, detectable only when the physical characteristics of clot formation are studied by viscoelastic point-of-care tests like thromboelastography (TEG). Herein we present a case of a 66-year old male patient with left frontal convexity meningioma, scheduled for craniotomy and excision of tumor. Patient’s preoperative coagulation profile (as assessed by conventional tests) was within normal limits but he was bleeding profusely from the beginning of the surgery and there was massive bleeding during tumour resection. Based on findings of TEG which revealed a severe hypocoagulable picture (low α angle, MA value and CI value with high K value), 10 units of cryoprecipitate and 4 units of random donor platelets were transfused intra-operatively in addition to 2 units of PRBCs. Haemodynamic stability was achieved and subsequent intra-operative course was better. One more unit of PRBC was transfused in the immediate post-operative period and a repeat TEG after 4 hours showed a trend towards normalization of TEG parameters suggesting a restoration of coagulation competency which also correlated with improved clinical condition of the patient.
Authors and Affiliations
Dr. Hemlata
Keywords
Related Articles
- EP ID EP362532
- DOI 10.24321/2349.7181.201815
- Views 109
- Downloads 0
Assessing Diastolic Hypertension in Patients of Primary Hypothyroidism among Adults Visiting a Tertiary Care Hospital in North India
Background: Elevation of diastolic BP has been shown in few studies among patients with hypothyroidism. However, the evidence is still obsolete when it comes to Indian settings. This study intends to evaluate association...
A case of Steroid Responsive Encephalopathy associated with Autoimmune Thyroiditis: A Diagnostic Dilemma
We present a case of 42 year-old female, who presented with generalized tonic-clonic seizures with altered sensorium, not responding to antiepileptic medications. She was a diagnosed case of hypothyroidism since last thr...
Usefulness of an Initial Single Intravenous Immunoglobulin Infusion with Delayed Use of Aspirin against Kawasaki Disease Relapse: A Single-Center Retrospective Study
Background: Kawasaki Disease (KD) relapse is a risk factor for Coronary Artery Lesion (CAL) development. However, the frequency and outcomes of patients with relapse remain unclear. Objective: To determine the frequency...
The Prevalence of Transfusion-Transmitted Infections (TTIs) and Distribution Pattern of ABO Rh Blood Group in Blood Donors and Possible Correlation of TTIs with ABO and Rh Blood Groups – A Study at RBTC (North-West) Delhi
Hepatitis B, Hepatitis C and HIV infections represent global health problems of significant magnitude. There are studies and hypothesis which suggest that genetic predispositions like ABO and Rh blood group may affect oc...
Overlap Syndrome of Autoimmune Hepatitis and Primary Biliary Cirrhosis: A Clinical Enigma
“Overlap syndrome” is a term used to describe variant forms of autoimmune hepatitis (AIH) which present with characteristics of AIH and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). Patients wi...