title: Spontaneous intracranial hemorrhage in children: report of a hemophilia patient who survived due to a brain cyst.
abstract: We report the case of a 2-year-old child who survived an acute episode of severe spontaneous intracranial hemorrhage with clinical and radiological signs of intracranial hypertension and transtentorial herniation. The patient underwent emergency surgery to drain the hematoma, and a catheter was inserted to monitor intracranial pressure. In the initial computed tomography analysis performed prior to hematoma drainage, a brain cyst was evident contralateral to the hematoma, which, based on the analysis by the care team, possibly helped to avoid a worse outcome because the cyst accommodated the brain after the massive hemorrhage. After the investigation, the patient was determined to have previously undiagnosed hemophilia A. The patient underwent treatment in intensive care, which included the control of intracranial pressure, factor VIII replacement and discharge without signs of neurological impairment.
authors.affiliation: Unidade de Terapia Intensiva Pediátrica, Hospital Santa Catarina, São Paulo, SP, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: Colleti Junior
authors.affiliation: Unidade de Terapia Intensiva Pediátrica, Hospital Santa Catarina, São Paulo, SP, Brazil.
authors.forename: Walter
authors.initials: W
authors.lastname: Koga
authors.affiliation: Instituto da Criança, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Werther Brunow
authors.initials: WB
authors.lastname: de Carvalho
mesh_terms: D001921:Brain / Q000473:pathology; D002675:Child, Preschool; D003560:Cysts / Q000209:etiology / Q000473:pathology; D005169:Factor VIII / Q000008:administration & dosage; D006406:Hematoma / Q000209:etiology / Q000473:pathology; D006467:Hemophilia A / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D019586:Intracranial Hypertension / Q000209:etiology*; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D005169:Factor VIII