Fulkerson Daniel H, Weyhenmeyer Jonathan, Archer Jacob B, Shaikh Kashif A, Walsh Mark
Beacon Children's Hospital, North Central Neurosurgery, Beacon Medical Group, South Bend, Indiana, USA,
Department of Neurosurgery, Indiana University School of Medicine, Goodman Campbell Brain and Spine, Indianapolis, Indiana, USA.
Pediatr Neurosurg. 2019;54(5):293-300. doi: 10.1159/000501117. Epub 2019 Aug 7.
Thromboelastography (TEG) is a point-of-care test that evaluates the entire hemostatic process. The use of TEG is expanding in multiple pediatric surgical disciplines. However, there is very little literature regarding its application in pediatric neurosurgical patients.
The authors provide a case-based update and literature review regarding potential applications of TEG to pediatric neurosurgical patients.
The authors describe a 12-year-old female who experienced a number of complications after a craniopharyngioma resection. The patient suffered multiple new intraventricular hemorrhages with removal of external ventricular drains. Standard coagulopathy tests did not reveal any abnormalities. However, an abnormal TEG value suggested primary hyperfibrinolysis, which led to a change in medical management. The patient did not suffer any further bleeding episodes after the change in treatment.
The authors discuss a case where TEG influenced patient management and identified a problem despite normal values of standard laboratory tests. Neurosurgeons should be aware of the potential benefits for TEG testing in pediatric patients.
血栓弹力图（TEG）是一种即时检验，可评估整个止血过程。TEG在多个小儿外科领域的应用正在不断扩大。然而，关于其在小儿神经外科患者中的应用的文献却非常少。
作者提供了一个基于病例的最新情况以及关于TEG在小儿神经外科患者中的潜在应用的文献综述。
作者描述了一名12岁女性，她在颅咽管瘤切除术后出现了多种并发症。患者在拔除脑室外引流管后发生了多次新的脑室内出血。标准凝血功能检查未发现任何异常。然而，异常的TEG值提示原发性纤溶亢进，这导致了医疗管理的改变。治疗改变后患者未再发生出血事件。
作者讨论了一个TEG影响患者管理且在标准实验室检查值正常的情况下发现问题的病例。神经外科医生应意识到TEG检测在小儿患者中的潜在益处。
