title: Multifocal subdural hematomas as the presenting sign of acquired hemophilia A: a case report.
abstract: BACKGROUND
  Acquired hemophilia A (AHA) is a rare coagulopathy linked to a variety of etiologies including autoimmune diseases, neoplasms, diabetes, respiratory diseases, and the post-partum state. While bleeding in AHA is often seen in mucocutaneous or intramuscular locations, intracranial and intraspinal bleeds are exceedingly rare.
  
  
  METHODS
  We report an unusual case of spontaneous multifocal subdural hematomas in a 25 year old Asian woman with lupus who presented with headache and backache, and was found to have an elevated partial thromboplastin time (PTT) level and new diagnosis of AHA.
  
  
  CONCLUSIONS
  Subdural hematomas as the initial sign of AHA are all but unknown in the medical literature. We bring this entity to the attention of the neurology community because lumbar puncture and/or conventional angiogram are often indicated in the work-up of idiopathic multifocal subdural hematomas, but may be dangerous in patients with AHA.
authors.affiliation: Department of Neurology, University of California, San Francisco, USA. mark.burish@ucsf.edu.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Burish
authors.forename: Aimee
authors.initials: A
authors.lastname: Aysenne
authors.forename: Vineeta
authors.initials: V
authors.lastname: Singh
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000209:etiology; D006408:Hematoma, Subdural / Q000175:diagnosis* / Q000209:etiology; D006467:Hemophilia A / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D010314:Partial Thromboplastin Time