The significance of thrombocytopenia in the development of postoperative intracranial hematoma

✓ A group of 35 patients undergoing intracranial surgery who exhibited perioperative thrombocytopenia (platelet count < 150,000/µl) was studied retrospectively. Of the 35 patients, 14 (40%) developed postoperative intracranial hematomas requiring reoperation and seven (20%) died within 2 weeks after the operation. Analysis revealed that a perioperative platelet count below 100,000/µl in a patient who failed to respond to platelet transfusions was associated with a higher risk of postoperative hematoma formation. All six patients with this profile developed postoperative hematomas. If the platelet count rose promptly from below 100,000/µl to a normal level after platelet transfusions, the incidence of hematoma formation decreased dramatically. None of the three patients with this response developed postoperative hematoma. In patients in whom an acute drop in platelet count from the normal range to between 100,000 and 124,000/µl occurred in the immediate perioperative period, there was a significantly highe...