Top

Published in:

01-03-2010 | Case Report

Factor XIII deficiency as a potential cause of supratentorial haemorrhage after posterior fossa surgery

Authors: Charikleia Spyridon Vrettou, Lampis C. Stavrinou, Spyridon Halikias, Magdalini Kyriakopoulou, Spyridon Kollias, George Stranjalis, Antonia Koutsoukou

Published in: Acta Neurochirurgica | Issue 3/2010

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.

Ariens RAS, Lai TS, Weisel JW, Greenberg CS, Grant PJ (2002) Role of factor XIII in fibrin clot formation and effects of genetic polymorphisms. Blood 100(3):743–754. doi:10.1182/blood.V100.3.743 CrossRefPubMed

Brisman MH, Bederson JB, Sen CN, Germano IM, Moore F, Post KD (1996) Intracerebral haemorrhage occurring remote from the craniotomy site. Neurosugery 39(6):1114–1121. doi:10.1097/00006123-199612000-00009 CrossRef

Catani MV, Bernassola F, Rossi A (1998) Inhibition of clotting factor XIII activity by nitric oxide. Biochem Biophys Res Commun 249(1):275–278. doi:10.1006/bbrc.1998.9130 CrossRefPubMed

Duckert F, Jung E, Shmerling DH (1960) A hitherto undiscribed congenital haemorrhagic diathesis probably due to fibrin stabilizing factor deficiency. Thromb Diath Haemorrh 5:179–186PubMed

Fukamachi A, Koizumi H, Nukui H (1985) Postoperative intracerebral hemorrhages. A survey of computed tomographic findings after 1,074 intracranial operations. Surg Neurol 23(6):575–580. doi:10.1016/0090-3019(85)90006-0 CrossRefPubMed

Gerlach R, Tolle F, Raabe A, Zimmermann M, Siegemund A, Seifert V (2002) Increased risk of postoperative haemorrhage after intracranial surgery in patients with decreased FXIII activity. Stroke 33(6):1618–1623. doi:10.1161/01.STR.0000017219.83330.FF CrossRefPubMed

Harders A, Gilsbach J, Weigel K (1985) Supratentorial space occupying lesions following infratentorial surgery. Early diagnosis and treatment. Acta Neurochir (Wien) 74(1-2):57–60. doi:10.1007/BF01413279 CrossRef

Huang QQ, Teng MK, Niu LW (1999) Purification and characterization of two fibrinogen-clotting enzymes from five pace snake (Ankystrodon acutus) venom. Toxicon 37(7):999–1013. doi:10.1016/S0041-0101(98)00228-1 CrossRefPubMed

Kalfas IH, Little JR (1988) Postoperative haemorrhage: a survey of 4,992 intracranial procedures. Neurosurgery 23(3):343–347. doi:10.1097/00006123-198809000-00010 PubMedCrossRef

10.

König A, Laas R, Herrmann HD (1987) Cerebellar haemorrhage as a complication after supratentorial craniotomy. Acta Neurochir (Wien) 88:104–108. doi:10.1007/BF01404145 CrossRef

11.

Lorand L (1994) Acquired inhibitors of fibrin stabilization: a class of hemorrhagic disorders of diverse origins. In: Green D (ed) Anticoagulants: Physiologic, pathologic and pharmacologic CRC pres, pp169-191

12.

Muszbeck L, Adany R, Mikkola H (1996) Novel aspects of blood coagulation factor XIII. Structure, distribution, activation and function. Crit Rev Clin Lab Sci 33(5):357–421. doi:10.3109/10408369609084691 CrossRef

13.

Teich M, Longin E, Dempfle CE, Konig S (2004) Factor XIII deficiency associated with valproate treatment. Epilepsia 45(2):187–189. doi:10.1111/j.0013-9580.2004.28302.x CrossRefPubMed

14.

Undas A, Brummel KE, Musial J, Mann KG, Szczeklik A (2001) Simvastatin depresses blood clotting by inhibiting activation of prothrombin, factor V, and factor XIII and by enhancing factor Va inactivation. Circulation 103(18):2248–2253PubMed

Title: Factor XIII deficiency as a potential cause of supratentorial haemorrhage after posterior fossa surgery
Authors: Charikleia Spyridon Vrettou
Lampis C. Stavrinou
Spyridon Halikias
Magdalini Kyriakopoulou
Spyridon Kollias
George Stranjalis
Antonia Koutsoukou
Publication date: 01-03-2010
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 3/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-009-0432-0

2024 ASCO Annual Meeting

Springer Medicine

Factor XIII deficiency as a potential cause of supratentorial haemorrhage after posterior fossa surgery

Abstract

Background

Aim

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Aim

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2010

Preliminary observation on predicting the need for coil extraction during microsurgery: the clip-coil ratio

Surgical complications of decompressive craniectomy for head trauma

Surgical exposure of the carotid artery for endovascular interventional procedures

A primary atypical solitary fibrous tumor of the sella mimicking nonfunctional pituitary adenoma: a case report

Huge intramedullar neurenteric cyst with intrathoracic development in a 1 month-old boy: excision though the anterior approach. A case report and review of the literature

Ruptured aneurysms of the choroidal branches of the posterior inferior cerebellar artery: a review of the literature and a case report