title: Conservative Treatment of Chronic Subdural Hematoma in HIV-Associated Thrombocytopenia with Tranexamic Acid.
abstract: Chronic subdural hematomas (CSDHs) and its management comprise a majority work in a neurosurgical specialty. The effectiveness of surgery is beyond doubt and sometimes even lifesaving in severe cases. However, the straightforward surgery is sometimes complicated by the associated comorbidities of the patient. Comorbidities in the form of coagulopathies secondary to chronic liver diseases, drugs (warfarin, ecosprin, clopidogrel), thrombocytopenia secondary to systemic illness are always a challenge to deal with in patients with CSDH. The authors encountered a patient with thrombocytopenia secondary to systemic HIV infection who presented with CSDH. Her coagulation profile was severe enough to preclude surgery. She was managed conservatively with tranexamic acid and responded well. The authors present the challenges they faced in the course of successful management of this patient.
authors.affiliation: 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Raja K
authors.initials: RK
authors.lastname: Kutty
authors.affiliation: 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Peethambaran
authors.affiliation: 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India.
authors.lastname: Sunilkumar
authors.affiliation: 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India.
authors.forename: M
authors.initials: M
authors.lastname: Anilkumar
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D000072700:Conservative Treatment; D005260:Female; D015658:HIV Infections / Q000150:complications*; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D013921:Thrombocytopenia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D014148:Tranexamic Acid
keywords: HIV infection; chronic subdural hematoma; thrombocytopenia; tranexamic acid