Serum S-100B As an Indicator of Early Postoperative Deterioration After Meningioma Surgery (General Clinical Chemistry‪)‬

Meningiomas, which constitute 15% of primary brain tumors in adults, are extraaxial, slow-growing, and histologically mostly benign. Although total resection and cure seems plausible, patients with meningiomas may still have an unsuccessful outcome because of postoperative exacerbation of a preexisting peritumoral vasogenic edema (PTVE) [4] (1-5) or the development of a completely new edema or postoperative hematoma. The exact pathogenesis of PTVE remains unclear; it may be present in various degrees, and it may cause intraoperative difficulties as well as postoperative deterioration with increased mortality and morbidity. PTVE occurs in 45-92% of patients (2, 3). On the other hand, a simple blood test indicative of ongoing organic brain damage could be more sensitive than a decrease in Glasgow Coma Score or an increase in intracranial pressure in ventilated patients for early detection of postcraniotomy deterioration of preexisting PTVE or the development of edema or hematoma (as a consequence of surgical trauma). Despite the fact that serum S-100B protein is an established neurochemical marker of organic brain damage in head injury and stroke (6-12), there have been no studies involving neurochemical monitoring in the early postoperative period after meningioma surgery.