The diagnostic value of erythrocyte sedimentation rate in management of brain tumors

Authors: Mirzayan, M. Javad1; Gharabaghi, Alireza2; Samii, Madjid3; Frömke, Cornelia4; Tatagiba, Marcos2; Krauss, Joachim K.1; Rosahl, Steffen K.5

Source: Neurological Research, Volume 31, Number 5, June 2009 , pp. 514-517(4)

Publisher: Maney Publishing

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Abstract:

Objective: Erythrocyte sedimentation rate (ESR) is considered as an indicator of inflammatory processes, and it has a prognostic value in the management of specific neoplastic diseases. It also responds to surgical intervention. There is very little data about the alteration of ESR in patients with brain tumors and information on its course after intracranial tumor surgery is completely lacking.

Methods: ESR was measured for 10 days in 46 patients (19 women and 27 men; mean age: 49.7 years; range: 13-70 years) who underwent elective craniotomy for tumor microsurgery (70-425 minutes with a mean of 230 minutes) under general anaesthesia. Blood samples were taken on the day before surgery and on each consecutive day after surgery for 10 days. The standard method of measuring ESR was based on the technique first described by Westergren.

Results: The mean ESR level on the day before surgery was 8.26 ± 7.27 mm/h after 1 hour and 14.80 ± 10.36 mm/h after 2 hours. After tumor surgery, ESR increased stepwise. The mean peak value of 22.89 ± 13.41 mm/h after the first hour was reached on the third post-operative day. Whereas mean values varied over time, ESR remained increased and did not decline to normal values until the tenth post-operative day. The mean ESR peak value was higher in patients having undergone surgery for intra-axial lesions (31.36 ± 30.43 mm/h on the post-operative day 6) as compared to patients with extra-axial lesions (21.31 ± 12.20 mm/h on the post-operative day 3).

Conclusion: ESR is not relevantly increased in patients harboring brain tumors. Because it remains elevated until the tenth post-operative day after uneventful craniotomy and generally responds more slowly than other indicators like C-reactive protein, it is also not suitable for the detection of post-operative infective complications.

Keywords: BRAIN TUMOR; CRANIOTOMY; ERYTHROCYTE SEDIMENTATION RATE; INTRACRANIAL SURGERY; NEUROSURGERY; POST-OPERATIVE INFECTION

Document Type: Research article

DOI: 10.1179/174313208X355459

Affiliations: 1: Department of Neurosurgery and Biometry, Medical School Hannover, Hannover, Germany 2: Department of Neurosurgery, University Hospital, Tuebingen, Germany 3: International Neuroscience Institute Hannover, Hannover, Germany 4: Department of Biometry, Medical School Hannover, Germany 5: Department of Neurosurgery, Helios Klinikum, Erfurt, Germany

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