[Levels of C-reactive protein and complement 4 fraction in hyperthermia secondary to microsurgical vascular decompression for trigeminal neuralgia].

Serial tests for serum C-reactive protein (CRP) and C4 levels were carried out on 20 patients undergoing microvascular decompression (MVD) for trigeminal neuralgia with interposition of synthetic material (Teflon +/- Dacron). These proteins represent important elements of host defense mechanisms against invading pathogens and their serum levels might be of value in distinguishing bacterial meningitis from tissue reaction to synthetic material. According to post-operative pyrexia, patients were classified into three groups: gr 1 (n = 4): apyrexia, gr 2 (n = 11): pyrexia from 38 degrees C to 39 degrees C, gr 3 (n = 5): pyrexia upper 39 degrees C. Such frequent hyperpyrexia provides a clinical dilemma about meningitis. In 2 patients high CRP levels, 4 days after surgery, indicated the presence of meningitis. In all other patients, CRP levels were decreasing rapidly and normal levels were reached by day 8. All C4 levels were normal values. Measurements of CRP contributed to diagnose common meningitis reactions. These reactions seemed more frequent with Dacron and Teflon than with Teflon alone. Though non significative this difference deserves confirmation by fuller investigations.