Variations in hemostatic factors have been studied in 17 patients undergoing neurosurgical operations for intracerebral primary tumors. Clotting time (plastic and glass), recalcification time (Howell), plasma fibrinogen level, fibrin split products, partial thromboplastin time, Quick and platelet count were measured before and after the surgical procedure and several times during the following 24 hours. Hemostasis was significantly disturbed, with maximal hypercoagulability 2 hours after operation. In 3 patients, fundus examination showed occlusion of retinal vessels. In all cases the surgical trauma was relatively minor compared with severe cerebral contusion, but was nevertheless enough to disturb the measured parameters, which appear to be sensitive indicators for assessing the severity of cerebral lesions, especially in cases of contusion. A systematic fundus examination is also of diagnostic interest. The state of blood hypercoagulability may lead to disseminated intravascular clotting (DIC) and therefore prophylactic heparin therapy should be administered.
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