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¹Çukurova University School of Medicine, Departments of Neurosurgery, Anesthesiology and Reanimation, Adana, Turkey
²Çukurova University School of Medicine, Departments of Neurosurgery, Immunology, Adana, Turkey The neurosurgical operations used to treat various intracranial pathologies may affect the immune system in different ways. The main goal of this study was to determine whether the surgeries for intracranial aneurysm, meningioma and glial tumor cause immunodepression. In each of these three surgical patient groups, we measured monocytic human leukocyte antigen-DR expression and the plasma levels of inflammatory cytokines (tumor necrosis factor- α, interleukin-1 α, interleukin-6 and interleukin-8) in the preinflammatory response, and assessed whether these parameters could be used to predict postoperative infection. We also compared the different groups length of stay in the intensive care unit, and the duration of surgery for each group, to determine whether these factors influence infectious outcome. Thirty adult patients were divided into three equal groups, according to whether they underwent craniotomy in the treatment of an aneurysm, meningioma or glial tumor. We measured human leukocyte antigen-DR expression and levels of tumor necrosis factor-a, interleukin-la, interleukin-6 and interleukin-8 at four different time points, namely, the start of surgery (stage 1), 1 hour into the operation (stage II), 3 hours after surgery (stage III) and on postoperative day 3 (stage IV). There were no significant differences among the three groups, or between the infected and noninfected patients, with regard to age or the levels of human leukocyte antigen-DR expression, tumor necrosis factor- α, interleukin-l α, interleukin-6, or interleukin-8 at any of the four stages (p > 0.05 for all comparisons; Mann -Whitney U test). However, length of stay in intensive care and duration of surgery were both longer in the individuals who developed infection (p < 0.05). The study results suggest that surgeries for intracranial aneurysm, meningioma and glial tumor do not cause immunodepression. AIso, monocytic human leukocyte antigen-DR expression and plasma tumor necrosis factor-a, interleukin-la, interleukin-6 and interleukin-8 levels representative of the preinflammatory response are not good predictors of postoperative infection. Prolonged stay in intensive care and longer duration of surgery are associated with the development of postoperative infection. Keywords : Human leukocyte antigen-DR, immunodepression, interleukin-1 α, interleukin-6, interleukin-8, tumor necrosis factor- α