Complications of treatment: pulmonary embolism following craniotomy for meningioma.
We present two case reports of patients who suffered a pulmonary embolism (PE) in the week following surgery for removal of a meningioma. Both patients were anticoagulated in the first week following surgery, and as a result, both suffered intracerebral bleeds requiring further surgery. An inferior vena caval (IVC) filter was then used in both patients to prevent further embolic events. Following our experience, we believe that it is dangerous to use intravenous anticoagulation within 6 days of cranial surgery for removal of a meningioma. We have reviewed the literature concerning the present guidelines for thromboembolic prophylaxis in patients requiring neurosurgery and believe that consideration of subcutaneous low-molecular-weight heparin should now be given to all patients requiring craniotomy for removal of a meningioma.
Brosnan
C
C
Department of Anaesthetics, Atkinson Morley's Hospital, Wimbleton, London, England.
Razis
P
P
D000925:Anticoagulants / Q000009:adverse effects*; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology* / Q000517:prevention & control; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D016306:Vena Cava Filters
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight