Abstract
Introduction
Intracerebral hemorrhage is the second most common cause of mortality (after infections) in acute leukemia and is responsible for approximately 20% of deaths due to acute leukemia. Management of intracerebral hemorrhage (ICH) is mostly conservative but there exist certain patients who need emergent surgery due to the poor Glasgow Coma Scale (GCS) despite their coagulopathic state.
Case report
We present here two such cases which were successfully managed with decompressive craniectomy which was done as a damage control surgery thus stating the importance of surgical intervention in the management of acutely deteriorating patients rather than the commonly employed conservative management due to their coagulopathic state.
Similar content being viewed by others
References
Recht L, Mrugala M (2003) Neurologic complications of hematologic neoplasms. Neurol Xlin Nam 21:87–105
Graus F, Rogers LR, Posner JB (1985) Cerebrovascular complications in patients with cancer. Medicine (Baltimore) 64:16–35
Pardes-Chavanes P, Afanetti M, Boyer C, Poirée M (2016) Fatal central nervous system hemorrhage during acute lymphoblastic leukemia induction. Archives de pediatrie: organe officiel de la Societe francaise de pediatrie 23(12):1260
Kim H, Lee J, Choi S et al (2004) Analysis of fatal intracranial haemorrhage in 792 acute leukemia patients. Hematologica 89(5):622–624
Patil S, Nourbakhsh A, Thakur JD, Khan IS, Guthikonda B (2013) Fatal intracranial hemorrhage as the initial presentation of acute lymphocytic leukemia: a case report. Turkish neurosurgery 23(4):568–571
Naunheim MR, Nahed BV, Walcott BP, Kahle KT, Soupir CP, Cahill DP, Borges LF (2010) Diagnosis of acute lymphoblastic leukemia from intracerebral hemorrhage and blast crisis. A case report and review of the literature. Clin Neurol Neurosurg 112(7):575–577
Mendelow AD, Gregson BA, Fernandes HM, Murray GD et al (2005) Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet 365:387–397
Quinones-Hinojosa A, Gulati M, Singh V et al (2003) Spontaneous intracerebral hemorrhage due to coagulation disorders. Neurosurg Focus 15:E3
Rauta S, Sahoo AK (2014) Acute promyelocytic leukemia in a 17-year male presenting as intracerebral haemorrhage. Bangladesh Journal of Medical Science 13(1):88–90
Ruggiero A, Attinà G, Piastra M, Maurizi PA, Mastrangelo ST, Pietrini D, Riccardi RI (2009) Severe hyperleukocytosis and multifocal intracranial haemorrhage: not always a fatal outcome. Int J Hematol 90(1):87–90
Fung C, Murek M, Z’Graggen WJ, Krähenbühl AK, Gautschi OP, Schucht P, Gralla J, Schaller K, Arnold M, Fischer U, Mattle HP (2012) Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage. Stroke 43(12):3207–3211
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Funding
None.
Rights and permissions
About this article
Cite this article
Singh, J., Garg, K., Sharma, R. et al. Damage control surgery in intracerebral hemorrhage in acute leukemia: a review of two cases. Childs Nerv Syst 33, 1229–1232 (2017). https://doi.org/10.1007/s00381-017-3401-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-017-3401-6