Diagnosis and treatment of intracranial hemorrhage in children with hemophilia.
Intracranial hemorrhage (ICH) is a significant complication for children with hemophilia. Identifying risk factors may allow us to establish clinically relevant guidelines for the diagnosis and management of ICH. The purpose of this review is to nucleate evidence from the available literature on the incidence, risk factors, presentation, treatment, and outcomes of ICH that can be utilized to develop a clinically useful framework for the diagnosis and management of hemophiliac patients with the condition. An electronic MEDLINE and EMBASE literature search was undertaken using the key words 'intracranial hemorrhage and hemophilia' and setting limits as: Last 10 years and Review or Randomized Controlled Trial (RCT) or Clinical Trial, or Practice Guidelines. Following review of all articles using predetermined search words and criteria, 31 were retrieved with sufficient data to address our objectives. An algorithm is presented for the management of children (≥3 years-18 years) with hemophilia and suspected ICH. A standardized approach to ICH may reduce unnecessary exposure to radiation via computed tomography scan in a select group of children. Currently there is limited scientific evidence to recommend a diagnostic and therapeutic algorithm for neonates with hemophilia.
Hamilton Health Sciences/McMaster Children's Hospital, Hamilton, Ontario, Canada.
Kim
K
Nagel
Mohan K
MK
Pai
Bosco A
BA
Paes
Anthony K
AK
Chan
D000293:Adolescent; D000465:Algorithms; D001720:Birth Injuries / Q000150:complications; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000150:complications; D019468:Disease Management; D005164:Factor IX / Q000037:antagonists & inhibitors / Q000276:immunology / Q000627:therapeutic use; D005169:Factor VIII / Q000037:antagonists & inhibitors / Q000276:immunology / Q000627:therapeutic use; D005260:Female; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000191:economics / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D007518:Isoantibodies / Q000097:blood; D007902:Length of Stay; D008297:Male; D015201:Meta-Analysis as Topic; D015997:Neonatal Screening; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001779:Blood Coagulation Factors; D007518:Isoantibodies; D005169:Factor VIII; D005164:Factor IX; C065655:anti-inhibitor coagulant complex