Splenic artery embolization in the management of an acute immune thrombocytopenic purpura-related intracranial hemorrhage.
Although relatively rare, intracranial hemorrhage remains the most common cause of immune thrombocytopenic purpura-related mortality [Medeiros D. Current controversies in the management of idiopathic thrombocytopenic purpura during childhood. Pediatr Clin North Am . 1996;43:757-72]. The required decompressive treatment has the potential for substantial blood loss and must often be delayed because of resistant thrombocytopenia responsive only to splenectomy. Splenic embolization is a novel approach to this problem that can expedite definitive neurosurgical care and minimize permanent sequelae. This is the first reported case of splenic embolization in the management of a child with known immune thrombocytopenic purpura presenting with central nervous system bleeding.
Puapong
Devin
D
Division of Pediatric Surgery and Interventional Radiology, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA.
Terasaki
Keith
K
Lacerna
Melinda
M
Applebaum
Harry
H
D001925:Brain Damage, Chronic / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000628:therapy*; D002648:Child; D003128:Coma / Q000209:etiology; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D006406:Hematoma / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008863:Microspheres; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000601:surgery; D015642:Radiology, Interventional; D013156:Splenectomy; D013157:Splenic Artery; D013159:Splenic Infarction / Q000209:etiology / Q000601:surgery*; D014696:Ventriculostomy
D016756:Immunoglobulins, Intravenous; D011142:Polyvinyl Alcohol; D011241:Prednisone