[Spinal canal bleeding in hemophilia A].
Case 1: Sensory and motor paralysis below the L3 level developed in a moderate hemophilia A due to spinal epidural bleeding following lumbar anesthesia for the resection of retro-peritoneal hematoma. By the treatment with cryoprecipitates, the patient recovered to walk with sticks after laminectomy. Case 2: the patient had severe hemophilia A with 220 Bethesda units/ml of inhibitor. The patient suffered from epidural and intramedullary spinal bleeding from C3 to C7 and developed tetraplegia. Since the inhibitor titer was high, infusion therapy with FEIBA was performed. Paralysis gradually reduced to the T5 level, but the patient had both sensory and motor paralysis of the extremities. It is required that an effective hemostastic treatment for spinal canal bleeding in hemophilia A with high-responder inhibitor is established.
Morichika
S
S
Department of Pediatrics, Nara Medical University.
Shima
M
M
Imanaka
Y
Y
Nakajima
M
M
Iwasaki
S
S
Yoshioka
A
A
D000293:Adolescent; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D005121:Extremities; D005169:Factor VIII / Q000627:therapeutic use; D005340:Fibrinogen / Q000627:therapeutic use; D005353:Fibronectins / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications*; D006470:Hemorrhage / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D010243:Paralysis / Q000209:etiology; D013115:Spinal Canal; D013122:Spinal Diseases / Q000188:drug therapy / Q000209:etiology
D001779:Blood Coagulation Factors; D005353:Fibronectins; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen; C065655:anti-inhibitor coagulant complex