title: Acquired hemophilia A associated with internal border-zone infarction triggered by major hemorrhage of thigh and leg: a case report.
abstract: It is unusual to be complicated with cerebral infarction for bleeding disorders. We describe a first case of internal border-zone infarction (I-BZI) complicated with acquired hemophilia A. A 79-year-old man was introduced from other hospital by cerebral infarction and severe anemia. His left thigh and leg were swollen with subcutaneous bleeding. Activated partial thromboplastin time was 99.4 seconds. Factor VIII activity was less than 1% and Factor VIII inhibitor concentration was 85 BU, respectively. The platelet count and prothrombin time were normal. These results were consistent with the diagnosis of acquired hemophilia A. Magnetic resonance imaging of the brain showed multiple small infarction in bilateral internal border zone. To our knowledge, this is the first case of I-BZI complicated with acquired hemophilia A. This case suggested that major hemorrhage is one of the sole causes of I-BZI.
authors.affiliation: Department of Neurology, Nara City Hospital, Nara, Japan. Electronic address: zweatherconcrete@yahoo.co.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Neurology, Nara City Hospital, Nara, Japan.
authors.forename: Shuuhei
authors.initials: S
authors.lastname: Nagami
authors.affiliation: Department of Neurology, Nara City Hospital, Nara, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Department of Neurology, Nara City Hospital, Nara, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D020520:Brain Infarction / Q000150:complications*; D006467:Hemophilia A / Q000150:complications*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007866:Leg; D008297:Male; D013848:Thigh
keywords: Border-zone infarction; acquired hemophilia A; hypoperfusion; major hemorrhage