Abstract
With great interest I read the paper by Dr. Morsing et al. entitled “Hemophilia A and spinal epidural hematoma in children” [1]. The authors described a 13-months-old boy with Hemophilia A with irritability and unspecified pain, that refused to walk, but showed a normal neurological examination (except for a Horner syndrome on the right side) at presentation in the hospital, 48 h after the onset of the complaints. MRI of the spine resulted in the diagnosis of a large subacute posterior spinal epidural hematoma at C2-S1. Because of the absence of spinal cord compression symptoms, conservative treatment with correction of the coagulopathy and follow-up MRI was instituted. The boy did not need operative treatment, and the hematoma resolved completely within 3 weeks. The authors explained that this case illustrates that rapid and aggressive factor replacement and correction can lead to complete neurological recovery with conservative therapy in Hemophilia patients with SSEH.
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