Subarachnoid hemorrhage associated with von Willebrand's disease--case report.
A 59-year-old woman with type IIA von Willebrand's disease (VWD) presented with subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the right sylvian fissure and intracranial hemorrhage in the right temporal lobe. Angiography demonstrated an aneurysm at the bifurcation of the right middle cerebral artery. Neck clipping was performed on the 3rd day after the onset with intra- and postoperative administration of factor VIII/von Willebrand factor concentrate. No excessive bleeding occurred. Patients with prolonged bleeding time should be screened for VWD before surgery. This is a rare case of VWD presenting with SAH secondary to ruptured intracranial aneurysm. The clinical characteristics and the management of SAH in a patient with VWD are discussed.
Nakau
Reiko
R
Department of Neurosurgery, Kanazawa University School of Medicine, Ishikawa. reiko.nakau.@ujitoku.or.jp
Nomura
Motohiro
M
Kida
Shinya
S
Yamashita
Junkoh
J
Kinoshita
Akira
A
Nitta
Hisashi
H
Muramatsu
Naoki
N
D017542:Aneurysm, Ruptured / Q000150:complications*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000209:etiology*; D014842:von Willebrand Diseases / Q000150:complications*