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Published in: Child's Nervous System 9/2020

01-09-2020 | Computed Tomography | Original Article

Management of intracranial hemorrhage in hemophilia A patients

Authors: Mustafa Aras, Sukru Oral

Published in: Child's Nervous System | Issue 9/2020

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Abstract

Introduction

Intracranial hemorrhage due to head trauma in patients with hemophilia is a major cause of mortality and morbidity. The incidence of central nervous system bleeding in these patients is between 3 and 8%. In this study, we shared our experience on the treatment and follow-up of seven pediatric patients with hemophilia A who had intracranial bleeding due to trauma.

Materials and methods

Between 2010 and 2019, the clinical and radiological findings of seven pediatric patients with hemophilia A with intracranial hemorrhage were retrospectively evaluated in our clinic. One patient underwent operation owing to intracranial hemorrhage, and the other six underwent conservative treatment. Hemoglobin, aPTT (activated partial thromboplastin time), and factor VIII levels were measured at regular intervals. For intracranial hemorrhage follow-up, regular computed tomography (CT) was performed.

Results

All patients visited the emergency department with initial neurological complaints. Further, two of the seven patients died, one was treated with sequelae (cerebral palsy), and the other four were treated without sequelae.

Conclusions

Early diagnosis and treatment of intracranial hemorrhage is very important in patients with bleeding disorders. Factor VIII replacement should be performed in such patients prior to radiological examinations and consultations. The main objective should be to bring factor VIII levels to normal limits during their treatment and follow-up.
Literature
1.
go back to reference Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, Ludlam CA, Mahlangu JN, Mulder K, Poon MC, Street A (2013) Guidelines for the management of hemophilia. Haemophilia 19:e1–e47CrossRef Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, Ludlam CA, Mahlangu JN, Mulder K, Poon MC, Street A (2013) Guidelines for the management of hemophilia. Haemophilia 19:e1–e47CrossRef
2.
go back to reference Cho JY, Lee WS, Park YS, Lee SH, Koh JS (2016) Clinical characteristics and prognostic factors in hemophiliacs with intracranial hemorrhage: a single-center, retrospective experience. Indian J Hematol Blood Transfus 32:488–493CrossRef Cho JY, Lee WS, Park YS, Lee SH, Koh JS (2016) Clinical characteristics and prognostic factors in hemophiliacs with intracranial hemorrhage: a single-center, retrospective experience. Indian J Hematol Blood Transfus 32:488–493CrossRef
3.
go back to reference Nagel K, Pai MK, Paes BA, Chan AK (2013) Diagnosis and treatment of intracranial hemorrhage in children with hemophilia. Blood Coagul Fibrinolysis 24:23–27CrossRef Nagel K, Pai MK, Paes BA, Chan AK (2013) Diagnosis and treatment of intracranial hemorrhage in children with hemophilia. Blood Coagul Fibrinolysis 24:23–27CrossRef
4.
go back to reference Balak N, Silav G, Kilic Y, Timur C, Elmaci I (2007) Successful surgical treatment of a hemophiliac infant with nontraumatic acute subdural hematoma. Surg Neurol 68:537–540 discussion 540CrossRef Balak N, Silav G, Kilic Y, Timur C, Elmaci I (2007) Successful surgical treatment of a hemophiliac infant with nontraumatic acute subdural hematoma. Surg Neurol 68:537–540 discussion 540CrossRef
5.
go back to reference Colleti Junior J, Koga W, de Carvalho WB (2015) Spontaneous intracranial hemorrhage in children: report of a hemophilia patient who survived due to a brain cyst. Rev Bras Ter Intensiva 27:412–415CrossRef Colleti Junior J, Koga W, de Carvalho WB (2015) Spontaneous intracranial hemorrhage in children: report of a hemophilia patient who survived due to a brain cyst. Rev Bras Ter Intensiva 27:412–415CrossRef
6.
go back to reference Zakaria Z, Kaliaperumal C, Crimmins D, Caird J (2018) Neurosurgical management in children with bleeding diathesis: auditing neurological outcome. 21:38 Zakaria Z, Kaliaperumal C, Crimmins D, Caird J (2018) Neurosurgical management in children with bleeding diathesis: auditing neurological outcome. 21:38
7.
go back to reference Senapati SB, Mishra SS, Dhir MK, Das S (2016) Intracerebellar haemorrage in a haemophilia child. Asian J Neurosurg 11:179–179CrossRef Senapati SB, Mishra SS, Dhir MK, Das S (2016) Intracerebellar haemorrage in a haemophilia child. Asian J Neurosurg 11:179–179CrossRef
8.
go back to reference Hegde A, Nair R, Upadhyaya S (2016) Spontaneous intracerebral hemorrhage in hemophiliacs-a treatment dilemma. Int J Surg Case Rep 29:17–19CrossRef Hegde A, Nair R, Upadhyaya S (2016) Spontaneous intracerebral hemorrhage in hemophiliacs-a treatment dilemma. Int J Surg Case Rep 29:17–19CrossRef
9.
go back to reference Hermans C, Altisent C, Batorova A, Chambost H, De Moerloose P, Karafoulidou A, Klamroth R, Richards M, White B, Dolan G (2009) Replacement therapy for invasive procedures in patients with haemophilia: literature review, European survey and recommendations. Haemophilia 15:639–658CrossRef Hermans C, Altisent C, Batorova A, Chambost H, De Moerloose P, Karafoulidou A, Klamroth R, Richards M, White B, Dolan G (2009) Replacement therapy for invasive procedures in patients with haemophilia: literature review, European survey and recommendations. Haemophilia 15:639–658CrossRef
10.
go back to reference Tabibian S, Motlagh H, Naderi M, Dorgalaleh A (2018) Intracranial hemorrhage in congenital bleeding disorders. Blood Coagul Fibrinolysis 29:1–11CrossRef Tabibian S, Motlagh H, Naderi M, Dorgalaleh A (2018) Intracranial hemorrhage in congenital bleeding disorders. Blood Coagul Fibrinolysis 29:1–11CrossRef
11.
go back to reference Patiroglu T, Ozdemir MA, Unal E, Altuner Torun Y, Coskun A, Menku A, Mutlu FT, Karakukcu M (2011) Intracranial hemorrhage in children with congenital factor deficiencies. Childs Nerv Syst 27:1963–1966CrossRef Patiroglu T, Ozdemir MA, Unal E, Altuner Torun Y, Coskun A, Menku A, Mutlu FT, Karakukcu M (2011) Intracranial hemorrhage in children with congenital factor deficiencies. Childs Nerv Syst 27:1963–1966CrossRef
12.
go back to reference Pavithran K, Thomas M (2002) Spontaneous resolution of subdural hematoma in haemophilia. Haematologica 87:Elt03PubMed Pavithran K, Thomas M (2002) Spontaneous resolution of subdural hematoma in haemophilia. Haematologica 87:Elt03PubMed
13.
go back to reference Grelat M, Madkouri R, Bousquet O (2016) Acute isodense subdural hematoma on computed tomography scan-diagnostic and therapeutic trap: a case report. J Med Case Rep 10:43CrossRef Grelat M, Madkouri R, Bousquet O (2016) Acute isodense subdural hematoma on computed tomography scan-diagnostic and therapeutic trap: a case report. J Med Case Rep 10:43CrossRef
14.
go back to reference Majidi S, Rahim B, Gilani SI, Gilani WI, Adil MM, Qureshi AI (2016) CT evolution of hematoma and surrounding hypodensity in a cadaveric model of intracerebral hemorrhage. J Neuroimaging 26:346–350CrossRef Majidi S, Rahim B, Gilani SI, Gilani WI, Adil MM, Qureshi AI (2016) CT evolution of hematoma and surrounding hypodensity in a cadaveric model of intracerebral hemorrhage. J Neuroimaging 26:346–350CrossRef
15.
go back to reference Macellari F, Paciaroni M, Agnelli G, Caso V (2014) Neuroimaging in intracerebral hemorrhage. Stroke 45:903–908CrossRef Macellari F, Paciaroni M, Agnelli G, Caso V (2014) Neuroimaging in intracerebral hemorrhage. Stroke 45:903–908CrossRef
16.
go back to reference McDowell MM, Kellner CP, Barton SM, Mikell CB, Sussman ES, Heuts SG, Connolly ES (2013) The role of advanced neuroimaging in intracerebral hemorrhage. Neurosurg Focus 34:E2CrossRef McDowell MM, Kellner CP, Barton SM, Mikell CB, Sussman ES, Heuts SG, Connolly ES (2013) The role of advanced neuroimaging in intracerebral hemorrhage. Neurosurg Focus 34:E2CrossRef
Metadata
Title
Management of intracranial hemorrhage in hemophilia A patients
Authors
Mustafa Aras
Sukru Oral
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04528-3

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