Factor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity. We present an 8-month-old female patient who developed subdural hematoma after ventriculoperitoneal shunt surgery but not bleeding after choroid plexus papilloma due to FXIII deficiency.
Pial arteriovenous fistulas (PAVFs) are extremely rare vascular malformations of the brain, and associated with greater morbidity and mortality in neonates and infants. We reported a neonatal case of giant multi-hole PAVFs presented with heart failure and local brain atrophy. The challenges associated with the complexity, outcome and therapeutic options of neonatal PAVFs were discussed. In addition, a review of the published literature on cases of PAVFs diagnosed at neonatal age, over the last two decades, was performed. Comprehensive prognostic evaluation and an optimal treatment strategy offered by a multidisciplinary team at specialized centers should be assured for each case affected.
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