Persistent activation of thrombocytes in neurosurgical patients operated for primary brain tumours

A prospective study was designed to investigate whether platelet hyperactivity exists following neurosurgical removal of primary brain tumours. The level of β-thromboglobulin (βTG), a protein released by platelets during the activation process, was measured in the plasma of 13 consecutive patients prior to surgery (T 1) and on the first (T 2) and seventh (T 3) post-operative days. A significant and sustained increase in βTG levels from a baseline of 20.7±1.7 ng/ml (mean ± sem) at T1 to 37.0±5.2 ng/ml (p<0.005) at T 2 and 35.9±3.7 at T 3 (p<0.005) occurred. When patients were grouped according to tumour malignancy, significantly higher βTG levels were found in the malignant group at T 2 (51.8±6.3 ng/ml) when compared to the benign group (30.6±6.0 ng/ml) (p=0.025). Postoperative T 3 levels were linearly correlated to T 1 levels (r=0.58, p=0.04). This significant and sustained platelet activation that occurs following brain surgery may be part of the biochemical sequel leading to a hypercoagulable state and thrombo-embolic phenomena (TEP) in these patients.