title: Successful surgical treatment of a hemophiliac infant with nontraumatic acute subdural hematoma.
abstract: BACKGROUND
  The moderate hemophiliacs usually have no spontaneous bleeding, but bleed after minor or major trauma. The proper management of intracranial hemorrhage in hemophiliac children is a challenge.
  
  
  METHODS
  An 18-month-old male infant with moderate hemophilia A was admitted with fever, vomiting, and hypersomnia. There was no history of trauma or seizure. The CT scans showed an acute subdural hematoma in the right temporoparietooccipital region with midline shift and a coincidental right cerebellar arachnoid cyst. After bolus factor VIII replacement, a right temporoparietal craniotomy was performed, and the subdural hematoma was evacuated. The postoperative CT scans demonstrated no hematoma.
  
  
  CONCLUSIONS
  The possibility of intracranial hemorrhage in a moderate hemophiliac infant should be considered even if the patient has no history of trauma. The surgical treatment results in a successful outcome in hemophiliac children with subdural hematomas provided that an aggressive factor replacement therapy is initiated before surgery.
authors.affiliation: Department of Neurosurgery, Göztepe Education and Research Hospital, Istanbul, TR-34740, Turkey.
authors.forename: Naci
authors.initials: N
authors.lastname: Balak
authors.forename: Gōkalp
authors.initials: G
authors.lastname: Silav
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Kiliç
authors.forename: Cetin
authors.initials: C
authors.lastname: Timur
authors.forename: Ilhan
authors.initials: I
authors.lastname: Elmaci
mesh_terms: D003029:Coagulants / Q000008:administration & dosage; D005169:Factor VIII / Q000008:administration & dosage; D020199:Hematoma, Subdural, Acute / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male
chemical_list: D003029:Coagulants; D005169:Factor VIII