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Child's Nervous System

, Volume 25, Issue 8, pp 987–991 | Cite as

Spinal epidural hematoma in hemophilic children: controversies in management

  • Pilar Varela RoisEmail author
  • Manuel Rodríguez López
  • Beatriz Cabanas López de Vergara
  • Adolfo de la Lama Zaragoza
  • Jesús González García
  • Jorge Mañas Uxo
Case for Discussion

Abstract

Introduction and objective

Spinal epidural hematoma (SEH) is an uncommon complication in hemophilic children. It can produce rapidly progressive neurological deficits. We aim to discuss the different management options for these patients.

Case report

A 13-year-old boy with a history of hemophilia A was admitted with acute onset of localized spine pain and weakness. No trauma was reported on review of the history. Recombinant factor VIII aggressive replacement therapy was started. Spinal magnetic resonance imaging revealed an extradural mass lesion extending from D5 to D6 level. Emergency hemilaminectomies of D5 and D6 and evacuation of the clot were done. The patient made excellent recovery following surgery.

Conclusion

Early diagnosis and immediate aggressive replacement therapy are mandatory in the management of SEH. Prompt surgical decompression to avoid any permanent neurological deficit is a safe and effective treatment option for an SEH in selected hemophilic children.

Keywords

Spinal epidural hematoma Hemophilia Magnetic resonance imaging Factor VIII deficiency Spinal hemorrhage 

Notes

Acknowledgments

The authors wish to thank Professor Rene de Costa for his assistance with the editing of this paper.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Pilar Varela Rois
    • 1
    Email author
  • Manuel Rodríguez López
    • 2
  • Beatriz Cabanas López de Vergara
    • 2
  • Adolfo de la Lama Zaragoza
    • 1
  • Jesús González García
    • 1
  • Jorge Mañas Uxo
    • 3
  1. 1.Department of NeurosurgeryXeral-Cies HospitalVigoSpain
  2. 2.Department of HematologyXeral-Cies University HospitalVigoSpain
  3. 3.Department of RadiologyXeral-Cies University HospitalVigoSpain

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