Spontaneous Intracranial Extradural Hematoma in Sickle Cell Disease

Abstract

Spontaneous extradural hematoma is rare in patients with sickle cell disease. We report a clinical case of a 19-year-old young man with sickle cell anemia who presented a sickle cell crisis complicated by the development of multiple acute extradural and subgaleal hematomas that had not been treated surgically. We discuss the physiopathology of this event. Although it is rare, clinicians should be aware of this phenomenon as part of a spectrum of neurologic complications in these patients.

Keywords

sickle cell disease - crisis - extradural hematoma - subgaleal hematoma

• References

• 1 Page C, Gardner K, Height S, Rees DC, Hampton T, Thein SL. Nontraumatic extradural hematoma in sickle cell anemia: a rare neurological complication not to be missed. Am J Hematol 2014; 89 (2) 225-227
• 2 Kalala Okito JP, Van Damme O, Calliauw L. Are spontaneous epidural haematomas a rare complication? A report of two new cases. Acta Neurochir (Wien) 2004; 146: 407-410 ; discussion 410
• 3 Cabon I, Hladky JP, Lambilliotte A, Cotten A, Dhellemmes P. Uncommon etiology of extradural hematoma [in French]. Neurochirurgie 1997; 43 (3) 173-176
• 4 Anson JA, Koshy M, Ferguson L, Crowell RM. Subarachnoid hemorrhage in sickle-cell disease. J Neurosurg 1991; 75 (4) 552-558
• 5 Strouse JJ, Hulbert ML, DeBaun MR, Jordan LC, Casella JF. Primary hemorrhagic stroke in children with sickle cell disease is associated with recent transfusion and use of corticosteroids. Pediatrics 2006; 118 (5) 1916-1924
• 6 Arends S, Coebergh JA, Kerkhoffs JL, van Gils A, Koppen H. Severe unilateral headache caused by skull bone infarction with epidural haematoma in a patient with sickle cell disease. Cephalalgia 2011; 31 (12) 1325-1328
• 7 Bölke E, Scherer A. Sickle cell disease. CMAJ 2012; 184 (3) E201
• 8 Dahdaleh NS, Lindley TE, Kirby PA, Oya H, Howard III MA. A “neurosurgical crisis” of sickle cell disease. J Neurosurg Pediatr 2009; 4 (6) 532-535
• 9 Karacostas D, Artemis N, Papadopoulou M, Christakis J. Case report: epidural and bilateral retroorbital hematomas complicating sickle cell anemia. Am J Med Sci 1991; 302 (2) 107-109
• 10 Mallouh AA, Young M, Hamdan J, Salamah MM. Proptosis, skull infarction, and retro-orbital and epidural hematomas in a child with sickle cell disease. Clin Pediatr (Phila) 1987; 26 (10) 536-538
• 11 Naran AD, Fontana L. Sickle cell disease with orbital infarction and epidural hematoma. Pediatr Radiol 2001; 31 (4) 257-259
• 12 Resar LM, Oliva MM, Casella JF. Skull infarction and epidural hematomas in a patient with sickle cell anemia. J Pediatr Hematol Oncol 1996; 18 (4) 413-415
• 13 Sangle SA, Lohiya RV, Karne SS, Chugh A. Spontaneous epidural hematoma: a rare complication of sickle cell anemia. Neurol India 2011; 59 (2) 301-302
• 14 Ng WH, Yeo TT, Seow WT. Non-traumatic spontaneous acute epidural haematoma—report of two cases and review of the literature. J Clin Neurosci 2004; 11 (7) 791-793
• 15 Steinberg MH. Management of sickle cell disease. N Engl J Med 1999; 340 (13) 1021-1030
• 16 Wood DH. Cerebrovascular complications of sickle cell anemia. Stroke 1978; 9 (1) 73-75