Preoperative valproate administration does not increase blood loss during temporal lobectomy

Epilepsia
M M WardI J Rampil

Abstract

Surgical treatment is increasingly used for patients with medically re fractory seizures. Valproate (VPA) is an effective, widely used anticonvulsant in this patient population, but believed by some researchers to increase surgical bleeding because of quantitative thrombocytopenia and functional defects in platelet aggregation. Because we have observed no clinical evidence that perioperative administration of VPA increases blood loss or complications related to postoperative bleeding in patients undergoing temporal lobectomy at our institution, we sought to test this hypothesis. We made a retrospective review of the medical records of all patients who underwent epilepsy surgery at the University of California, San Francisco Medical Center, from September 1986 through January 1993. Patients who had a temporal lobectomy and whose medical records documented preoperative platelet counts and pre- and postoperative hematocrit and hemoglobin values were included. We excluded patients who had cranial surgery before temporal lobectomy and those with intracranial neoplasms or vascular malformations. Patients were divided into two groups: those who received VPA in the immediate preoperative period and those who had not received VPA recent...Continue Reading

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Citations

Apr 25, 2014·Neurosurgical Review·R BauerI Unterberger
Dec 3, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Emelie HedegärdKristina Malmgren
Jun 1, 2000·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·G Savard, R Manchanda
Mar 12, 2004·Epilepsy Research·Gail D AndersonH Richard Winn
Jul 5, 2008·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Stephan KoenigCarl-Erik Dempfle
May 18, 2010·Expert Review of Anticancer Therapy·Charles J Vecht, Erik B Wilms
Nov 3, 2011·Journal of Pain and Symptom Management·Paul HowardAndrew Wilcock
Jul 16, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Crystal ManoharJuan P Cata
Oct 10, 2015·Journal of Neurosurgery. Pediatrics·Marlin Dustin RichardsonTodd C Hankinson
Apr 17, 2007·Lancet Neurology·Melanie S M van BreemenCharles J Vecht
Aug 5, 2006·Epilepsia·Thorsten GerstnerStephan König
May 12, 2007·Seizure : the Journal of the British Epilepsy Association·Thorsten GerstnerStephan A Koenig
Nov 8, 2013·The Neurohospitalist·John ProbascoMichael Levy
Jul 16, 2003·Acta Neurologica Scandinavica·B Pohlmann-EdenC E Dempfle

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