Head trauma in hemophilia. A prospective study.
Intracranial hemorrhage (ICH) remains a serious problem in hemophilia. Consecutive episodes of ICH or reports of head trauma were prospectively recorded in 140 patients with hemophilia seen during a two-year period. Forty of 48 consecutive episodes of ICH or trauma occurred in 37 patients with severe disease (less than 1% factor VIII or IX). Five injured patients had inhibitors to factor VIII. Two fatalities occurred following injury and one patient died following a spontaneous bleed. Injury in 40 instances warranted replacement therapy. No patient given coagulation factor within six hours of injury experienced ICH. The risk of ICH following head trauma (13% in this series) warrants aggressive use of coagulation factor replacement. Watchfulness in dealing with such patients and early therapy may be more necessary than often realized.
D000293:Adolescent; D000328:Adult; D001779:Blood Coagulation Factors / Q000008:administration & dosage / Q000032:analysis; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000628:therapy; D006408:Hematoma, Subdural / Q000150:complications; D006467:Hemophilia A / Q000097:blood / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009461:Neurologic Manifestations
D001779:Blood Coagulation Factors