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Intracranial hemorrhage in the hemophiliacs
Insights
Prompt replacement therapy is crucial for hemophiliac children with suspected intracranial hemorrhage (ICH). Early treatment and prolonged care lead to survival and minimal neurological deficits.
Area of Science:
- Pediatric Hematology
- Neurology
- Medical Imaging
Background:
- Hemophilia A and B are bleeding disorders that can lead to serious complications.
- Intracranial hemorrhage (ICH) is a life-threatening event in children with hemophilia.
Purpose of the Study:
- To analyze the characteristics and outcomes of intracranial hemorrhage in hemophiliac children.
- To establish optimal management guidelines for ICH in this patient population.
Main Methods:
- Retrospective review of nine ICH episodes in eight hemophiliac children.
- Diagnosis confirmed by computed tomographic (CT) scan.
- Assessment of presenting symptoms, treatment protocols, and patient outcomes.
Main Results:
- Eight of nine ICH episodes occurred in children with hemophilia A.
- Headache and vomiting were the most common presenting symptoms.
- All patients received immediate replacement therapy and recovered without surgery, with one experiencing mild neurological sequela.
Conclusions:
- Prompt replacement therapy is vital for suspected ICH in hemophiliacs, even without trauma history.
- CT confirmation of ICH is essential.
- Prolonged replacement therapy and intracranial pressure management are recommended for documented ICH.
Abstract:
Five of 34 hemophiliac children suffered from nine episodes of intracranial hemorrhage (ICH) from hemophilia A, and another 3 were B hemophiliacs. Diagnoses were confirmed by computed tomographic scan in all nine episodes. The ages of the patients with ICH ranged from 3 months to 4 1/2 years. The most frequent presenting symptoms were headache and vomiting, followed by focal neurological deficits. Eight of 9 episodes had bleeding in multiple regions. All the patients received immediate replacement therapy had recovered without surgical intervention. The duration of treatment was 10 +/- 2 days. All the patients survived and only one of them had neurological sequela as left hand paresis. From this observation we suggest that the treatment of suspected ICH in hemophiliacs should include prompt replacement therapy for either trauma or neurological symptoms in the absence of trauma history, documentation of ICH by computed tomographic scan, and prolonged replacement therapy and control of increased intracranial pressure in hemophiliacs with documented ICH.