Spontaneous acute subdural haematoma and intracerebral haemorrhage in patient with HELLP syndrome: case report.
HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome can result in a fatal intracranial haemorrhage during the perinatal period. We report treatment of a 32-year-old primigravida who fell into a deep coma during labour with fetal distress, complicated by a spontaneous acute subdural haematoma and intracerebral haemorrhage. Simultaneous emergency operations, evacuation of the acute subdural haematoma and a caesarean section, were performed, during which a diagnosis of HELLP syndrome with disseminated intravascular coagulation was made. Both mother and infant recovered, though hemiparesis persisted in the mother. Patients with HELLP syndrome should be managed as high-risk, which requires an excellent working relationship of the physicians involved. Prompt recognition of intracranial haemorrhagic complications and neurosurgical intervention are particularly important.
Yokota
H
H
Department of Neurosurgery, Higashiosaka City General Hospital, Osaka, Japan. h-yokota@higashiosaka-hosp.jp
Miyamoto
K
K
Yokoyama
K
K
Noguchi
H
H
Uyama
K
K
Oku
M
M
D000328:Adult; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis*; D020199:Hematoma, Subdural, Acute / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000209:etiology