title: Factor XIII deficiency as a potential cause of supratentorial haemorrhage after posterior fossa surgery.
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).
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  We suggest that reduced FXIII activity may be an important but preventable predisposing factor to remote postoperative haemorrhage in neurosurgical patients.
authors: Critical Care Department and Pulmonary Services, Evangelismos General Hospital, University of Athens Medical School, Athens GR-10675, Greece. vrettou@hotmail.com
authors: Charikleia Spyridon
authors: CS
authors: Vrettou
authors: Lampis C
authors: LC
authors: Stavrinou
authors: Spyridon
authors: S
authors: Halikias
authors: Magdalini
authors: M
authors: Kyriakopoulou
authors: Spyridon
authors: S
authors: Kollias
authors: George
authors: G
authors: Stranjalis
authors: Antonia
authors: A
authors: Koutsoukou
mesh_terms: D001777:Blood Coagulation / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D002531:Cerebellum / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003128:Coma / Q000209:etiology; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D003560:Cysts / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D005177:Factor XIII Deficiency / Q000150:complications* / Q000235:genetics / Q000378:metabolism; D005260:Female; D006547:Hernia / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D019586:Intracranial Hypertension / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D013995:Time; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome