One of the operative case for intracranial hematoma in hemophilia B patient following head trauma

Abstract

Three-year-old boy with severe factor IX dificiency had developed frequent vomiting seven days after minor head injury. CT scan and CAG revealed a large intracranial hematoma in the left temporal lobe. Evacuation of the hematoma was performed. The factor IX concentrate was given to keep the plasma levels of factor IX at over 100% during operation and for 24 hours postoperatively, at 60% for following 6 days, and discontinued on 27 days after operation. Postoperative course was uneventful.Our retrospective study on total Hemophiliacs (number 153; Hemophilia A 132, B 21), we experienced 23 cases of intracranial bleeding in 13 patient (Hemophilia A 11, B 2). 13 of 23 cases of intracranial bleeding had a history of recent head trauma, two thirds of which had a long symptom-free interval (mean 4.8 days).Minor head trauma happens to cause rupture of intracranial small vessels, and continuous bleeding does not cease spontaneously in these patients to make a large intracranial hematoma during latent period. The prompt replacement therapy after head trauma even in the absence of symtom is the most important procedure for preventing intracranial bleeding.