Successful surgical treatment of a hemophiliac infant with nontraumatic acute subdural hematoma.
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.
Balak
Naci
N
Department of Neurosurgery, Göztepe Education and Research Hospital, Istanbul, TR-34740, Turkey.
Silav
Gōkalp
G
Kiliç
Yilmaz
Y
Timur
Cetin
C
Elmaci
Ilhan
I
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
D003029:Coagulants; D005169:Factor VIII