Abstract
The modern treatment, with concentrates of the deficient factors, of undue bleeding due to haemophilia is briefly discussed. Seven cases are described of haemophiliacs (including three with Christmas disease or factor IX deficiency) who developed serious complications following head injury. Six were young children. One case of extradural haematoma, two of subdural, one of intracerebral and one of a very large subaponeurotic haematoma of the scalp were operated on, and there was only one death (a case of subdural haemorrhage). Two other patients recovered without operation. All received treatment with concentrates of the deficient factor with the object of restoring normal blood coagulability, especially during and following surgical operation. Close collaboration with a specialized haematological department is necessary for this type of surgery. Appropriate therapy (fresh-frozen plasma, if concentrates are not available) should be started as soon as possible after injury. Angiography and operation should be avoided unless absolutely necessary and then, only the minimum operation performed which is likely to save life.
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