The aim of this study was to investigate the prevalence of abnormal preoperative screening prothrombin (PT) and partial thromboplastin times (PTT) in patients listed for primary cranial vault remodeling that required hematological workup, as well as their diagnoses and subsequent management. Methods: This retrospective analysis was performed from January 2000 to December 2003 at the International Craniofacial Institute, Dallas, Texas, on a total of 168 patients. Results: All patients had normal PT. Abnormally raised PTT was found in 6 patients (prevalence of 3.57%), 1 who had factor XI deficiency, 1 who had a borderline factor XI deficiency and circulating inhibitor, 1 who had an intermittent factor XI deficiency and circulating inhibitor, 1 who had a borderline von Wil-lebrand's disease (vWD) with low factor XII, and the remaining 2 who had a circulating inhibitor of coagulation. Of these 6 patients, the perioperative management was altered in 4 out of 5 patients, and 1 patient declined surgery out of fear of surgical morbidity. The surgery of patient C was aborted intraoperatively due to abnormal bleeding without clot formation after the calvarial burr holes had been drilled. The mean blood loss was 183 ml for the 4 patients with completed surgery and 100 ml for patientC. Conclusion: We conclude that even though the prevalence of abnormal screening PTT in these patients was low (3.57%), detection of an abnormal result required preoperative correction of coagulopathy in 80% of cases.
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