Central nervous system hemorrhage in thrombocytopenic patients: computed tomographic findings in 21 cases.
OBJECTIVE
To describe the CT scan findings of 21 thrombocytopenic patients with central nervous system (CNS) hemorrhage.


METHODS
Retrospective study of the computed tomography (CT) of 21 platelet-depleted patients with CNS hemorrhage. One patient presented two episodes of hemorrhagic episode with different intervals. The clinical data were obtained by the review of the medical records. Two radiologists analyzed the films and reached the decisions by consensus. The following findings were studied: type of bleeding, number of lesions, topography, laterality, size and associated findings.


RESULTS
Intraparenchymal hemorrhage (IPH) was the most common findings, found in 20 cases, being six of them associated with subarachnoid and intraventricular hemorrhages. The size of the lesions varied between 1.8 and 10.5 cm. The parietal lobes were more commonly affected (n=11, 50%), followed by the temporal (n=7, 31.8%), frontal (n=7, 31.8%) and occipital (n=2, 9.09%) lobes. In 15 cases (68.2%) there was a single area of hemorrhage and in the remaining cases there were multiple hemorrhages. Associated findings were found in 20 cases. The most prevalent were edema (n=17, 77.3%), hydrocephalus (10, 45.4%) and midline shift (n=9, 41%).


CONCLUSIONS
The most frequent CT scan findings in thrombocytopenic patients with CNS hemorrhage are single IPH, located mostly in the parietal, temporal and frontal lobes, with varied sizes and associated with edema, hydrocephalus and midline shift.
Gasparetto
Emerson L
EL
Department of Internal Medicine, University of Paraná School of Medicine, and Hospitalde Clínicas, Curitiba, Brazil. egasparetto@gmail.com
Benites Filho
Paulo R
PR
Davaus
Taísa
T
Carvalho Neto
Arnolfo de
Ad
D000328:Adult; D017677:Age Distribution; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D017678:Sex Distribution; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D013921:Thrombocytopenia / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed