Our Summary

This study looked at patients who had brain surgery to remove tumors, because they are at a higher risk of developing blood clots in their veins (venous thromboembolism or VTE). The researchers analyzed data from a national registry of surgical patients to identify factors that increase the risk of VTE after surgery.

They found that 629 out of 19,409 patients who had brain surgery to remove tumors (about 3%) developed VTE. They found that the risk of VTE was higher in patients who had other complications after surgery, including pneumonia, respiratory failure, stroke, and sepsis.

The study also identified several factors that independently increased the risk of VTE. These included being older (especially over 66), having a higher body mass index (BMI, a measure of body fat), being dependent on a ventilator, using steroids, having sepsis before surgery, and having a longer surgery time (especially over 271 minutes).

In simple terms, if you’re older, overweight, need a ventilator, use steroids, have had sepsis, or have a long surgery, you are at a higher risk of developing blood clots after brain surgery to remove a tumor.

FAQs

  1. What is the risk of developing venous thromboembolism (VTE) after brain surgery to remove tumors?
  2. What factors independently increase the risk of VTE after brain surgery?
  3. Do complications after surgery, such as pneumonia, respiratory failure, stroke, and sepsis, increase the risk of developing VTE?

Doctor’s Tip

To reduce your risk of developing blood clots after craniotomy, it is important to follow your doctor’s recommendations for post-operative care, including staying active and moving around as soon as possible after surgery. Your doctor may also recommend compression stockings or medication to help prevent blood clots. Be sure to discuss any concerns or questions you have with your healthcare provider.

Suitable For

Additionally, patients with a history of blood clots, heart disease, or a family history of VTE may also be at a higher risk and may be recommended to undergo a craniotomy with caution. Patients with certain types of brain tumors that are located in critical areas of the brain may also be recommended for a craniotomy to remove the tumor and relieve symptoms or prevent further complications.

Overall, the decision to recommend a craniotomy for a patient will depend on a variety of factors including the type and location of the brain tumor, the patient’s overall health and medical history, and the potential risks and benefits of the surgery. It is important for patients to discuss their individual situation with their healthcare provider to determine the best course of action.

Timeline

Before craniotomy:

  • Patient is diagnosed with a brain tumor and discusses treatment options with their healthcare provider
  • Patient undergoes preoperative evaluations and tests to determine if they are a suitable candidate for surgery
  • Patient may undergo radiation or chemotherapy before surgery to shrink the tumor
  • Patient is informed about the risks and benefits of the surgery, including the risk of developing blood clots
  • Patient is admitted to the hospital on the day of surgery and undergoes preoperative preparations

After craniotomy:

  • Patient undergoes the craniotomy procedure to remove the brain tumor
  • Patient is monitored closely in the ICU or recovery room post-surgery
  • Patient may experience pain, swelling, and discomfort at the surgical site
  • Patient is at risk for developing blood clots in the veins, especially if they have other complications post-surgery
  • Patient may be prescribed blood thinners to prevent blood clots
  • Patient undergoes follow-up appointments and imaging studies to monitor their recovery and check for any signs of complications

Overall, the timeline of a patient before and after craniotomy involves thorough preoperative evaluations, the surgical procedure itself, postoperative monitoring and management of complications, and long-term follow-up care to ensure the best possible outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about craniotomy include:

  1. What is the purpose of the craniotomy procedure and how will it benefit me?
  2. What are the potential risks and complications associated with craniotomy surgery?
  3. What is the likelihood of developing blood clots (venous thromboembolism) after the surgery?
  4. Are there any specific factors in my medical history that may increase my risk of developing blood clots after surgery?
  5. What preventive measures will be taken to reduce the risk of blood clots during and after the surgery?
  6. How long is the recovery process expected to take and what can I expect in terms of post-operative care?
  7. What symptoms should I watch out for that may indicate a potential blood clot after surgery?
  8. How often will I need follow-up appointments after the surgery to monitor for complications?
  9. Are there any lifestyle changes or medications I should consider to reduce my risk of blood clots after surgery?
  10. What is the success rate of this surgery in removing the tumor and what is the prognosis for my condition post-surgery?

Reference

Authors: Cote DJ, Dubois HM, Karhade AV, Smith TR. Journal: Semin Thromb Hemost. 2016 Nov;42(8):870-876. doi: 10.1055/s-0036-1592306. Epub 2016 Oct 20. PMID: 27764877