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Intracranial hemorrhage in a patient with severe hemophilia — case report
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Abstract
Hemophilia is a genetically inherited bleeding disorder, caused by deficiency or lack of clotting factor VIII (hemophilia A) or IX (hemophilia B). Treatment of bleeding in the course of the disease is based on the substitution of coagulation factors. The prognosis and treatment is more difficult in patients with elevated level of inhibitors of coagulation factor VIII or IX. Hemorrhage into the central nervous system (CNS) is one of the most serious complications of hemophilia, requiring intensive treatment and monitoring of the patient. Patient, 63 year old male with severe haemophilia A was admitted to the Department of Neurology and Stroke Treatment due to headaches and weakness of left limbs. We performed CT-scan and revealed hemorrhage in the right parieto-temporal region of brain, 65 × 45 mm in diameter, with edema of the right hemisphere. During the first day of hospitalization clotting factor activity was 85.3%, and the inhibitor activity — 1.3 Bethesda Units (BU/mL). Despite substitution treatment with high doses of concentrated factor VIII, in the control CT-scan of patients brain we found enlargement of the hemorrhage. It was decided to include bypassing agents (BPA) in the treatment. General and neurological condition of the patient improved and reduction of hemorrhage was revealed in the next CT-scan.
Abstract
Hemophilia is a genetically inherited bleeding disorder, caused by deficiency or lack of clotting factor VIII (hemophilia A) or IX (hemophilia B). Treatment of bleeding in the course of the disease is based on the substitution of coagulation factors. The prognosis and treatment is more difficult in patients with elevated level of inhibitors of coagulation factor VIII or IX. Hemorrhage into the central nervous system (CNS) is one of the most serious complications of hemophilia, requiring intensive treatment and monitoring of the patient. Patient, 63 year old male with severe haemophilia A was admitted to the Department of Neurology and Stroke Treatment due to headaches and weakness of left limbs. We performed CT-scan and revealed hemorrhage in the right parieto-temporal region of brain, 65 × 45 mm in diameter, with edema of the right hemisphere. During the first day of hospitalization clotting factor activity was 85.3%, and the inhibitor activity — 1.3 Bethesda Units (BU/mL). Despite substitution treatment with high doses of concentrated factor VIII, in the control CT-scan of patients brain we found enlargement of the hemorrhage. It was decided to include bypassing agents (BPA) in the treatment. General and neurological condition of the patient improved and reduction of hemorrhage was revealed in the next CT-scan.
Keywords
hemophilia A, bypassing agents (BPA), intercranial hemorrhage
About this articleTitle
Intracranial hemorrhage in a patient with severe hemophilia — case report
Journal
Journal of Transfusion Medicine
Issue
Article type
Case report
Pages
37-41
Published online
2015-02-24
Bibliographic record
Journal of Transfusion Medicine 2015;8(1):37-41.
Keywords
hemophilia A
bypassing agents (BPA)
intercranial hemorrhage
Authors
Łukasz Sokołowski
Paulina Sobieszak-Skura
Barbara Masłowska