A case of subdural hematoma with a medical history of hemophilia a and a review of related literature

Yi Zhao,Yuan-Fan Yang,Xin-Jie Bao,Wen-Bin Ma,Yong Yao,Jun-Ji Wei,Ren-Zhi Wang

doi:10.1186/s41016-018-0119-6

Abstract

BackgroundIntracranial hemorrhage is the most common emergency in the neurology department, and patients with a medical history of hemophilia have a risk of severe bleeding.Case presentationA 56-year-old man was admitted to the emergency department in our hospital. He was diagnosed with hemophilia A and subdural hematoma. We administered an infusion of factor VIII to decrease the risk of bleeding and improve the prognosis. Factor VIII infusion is the most important factor in treating hemophilia A patients.ConclusionWe recommend carefully checking coagulation function and the medical history once these patients are admitted, especially in the emergency department.

Highlights

Intracranial hemorrhage is the most common emergency in the neurology department, and patients with a medical history of hemophilia have a risk of severe bleeding.Case presentation: A 56-year-old man was admitted to the emergency department in our hospital
Hemophilia is a rare complication that increases the risk of bleeding in conditions such as subdural hematoma (SDH), Intracranial hemorrhage (ICH), and subarachnoid hemorrhage (SAH)
We administered an infusion of factor VIII and provided adjunctive treatment during the perioperative period, successfully saving his life

Summary

Background

Intracranial hemorrhage (ICH) is a common emergency in neurology departments and includes many complications. Hemophilia is a rare complication that increases the risk of bleeding in conditions such as subdural hematoma (SDH), ICH, and subarachnoid hemorrhage (SAH). We report a case of SDH in a male patient with a medical history of hemophilia. We summarize the characteristics of treatment for SDH patients with a history of hemophilia A through a literature review. We infused the patient with 2400 U (40 U/kg) of factor VIII during the operation. The APTT was 34–57 s 2 weeks after the operation When he was released from the hospital, factor VIII inhibitor was 0, and factor VIII activity was 25.9%. Myodynamia had recovered, and the Babinski sign was negative on both sides He had a follow-up visit 3 months after discharge, and right oculomotor and right eye movements were observed.

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Discussion

Conclusion