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Childs Nerv Syst. 2020 Feb 5. doi: 10.1007/s00381-020-04528-3. [Epub ahead of print]

Management of intracranial hemorrhage in hemophilia A patients.

Author information

1
Department of Neurosurgery, Ondokuzmayis University, Samsun, Turkey.
2
Department of Neurosurgery,, Kayseri City Hospital, Kocasinan Kayseri, Turkey. sukruor@yahoo.com.

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.

KEYWORDS:

Factor VIII; Hemophilia A; Intracranial hemorrhage

PMID:
32025871
DOI:
10.1007/s00381-020-04528-3

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