Surgical treatment of spontaneous intracerebral hemorrhage in a full-term infant with coagulopathy--case report.
An 11-week-old male infant presented with intracerebral hemorrhage associated with coagulopathy manifesting as left hemiparesis, lethargy, and vomiting. Computed tomography demonstrated extensive right frontoparietal intracerebral hemorrhage extending into the ventricular system. Liver function tests revealed abnormal values of transaminases and bilirubin. Blood coagulation studies showed prolonged prothrombin time (PT) and activated partial thromboplastin time (APPT). PT and APTT immediately normalized after the administration of vitamin K and fresh frozen plasma. Right parietal craniotomy and evacuation of the hematoma were performed because of the deterioration in consciousness and left hemiparesis. No vascular abnormality was observed in the hematoma cavity. After surgery, he became alert and the left hemiparesis improved. There is a risk of intracerebral hemorrhage due to vitamin K deficiency even if prophylactic administration of vitamin K was given. Surgical treatment should be considered for the treatment of infantile spontaneous intracerebral hemorrhage, especially if neurological deterioration is present.
Yokoyama
Shunichi
S
Division of Neurosurgery, Okinawa Chubu Hospital, Gushikawa, Okinawa, Japan. yokoyama_shunichi@hosp.pref.okinawa.jp
Takayama
Kenji
K
Murakami
Takahiro
T
Ishikawa
Yasunari
Y
Fujiwara
Naoki
N
Ganaha
Hitoshi
H
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000188:drug therapy; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011300:Preoperative Care; D014812:Vitamin K / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D014812:Vitamin K