Neuropediatrics 2009; 40(5): 245-248
DOI: 10.1055/s-0030-1248247
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Hemophilia A and Spinal Epidural Hematoma in Children

I.E. Morsing1 , P. Brons2 , J.M. Th. Draaisma1 , E.J. van Lindert3 , C.E. Erasmus4
  • 1Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • 2Department of Pediatric Hematology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • 3Department of Pediatric Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • 4Department of Pediatric Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Weitere Informationen

Publikationsverlauf

received 15.07.2009

accepted 13.01.2010

Publikationsdatum:
10. März 2010 (online)

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Abstract

Hemophilia A is an X-linked bleeding disorder, caused by deficient or defective blood coagulation factor VIII. The most characteristic symptoms of the severe forms of hemophilia A are joint and muscle bleeds. Intracranial hemorrhage occurs only in 3–10% of the patients. Spinal epidural hematomas are rarely seen. We describe a 13-month-old boy with hemophilia A who was admitted to the hospital because of irritability and unspecified pain for the past two days. There was no history of evident trauma, no fever. Physical investigation showed no skin lesions or hematomas and no obvious cause for the pain. Neurological examination showed a dysphoric toddler, mainly in the fetal position. No neurological abnormalities were found except for a miosis of the right pupil due to a suspected Horner syndrome. Magnetic resonance imaging of the spine showed an extensive epidural hematoma. The boy was successfully treated with intensive replacement therapy during three weeks and did not require surgical intervention. There was a rapid and complete clinical resolution. In conclusion, rare hematomas should be considered and searched for in children with bleeding disorders and not well understood complaints. Early diagnosis is important for the neurological outcome.

References

Correspondence

Indra E. Morsing

Radboud University

Nijmegen Medical Centre

Department of Pediatrics

Huispost 790

Postbus 9101

6500 HB Nijmegen

The Netherlands

Telefon: 024-3611111

eMail: i.morsing@cukz.umcn.nl