Appearance of isolated thrombocytopenia in a patient of acute subdural hematoma

Abstract

Thrombocytopenia in critically ill patients probably reflects the severity of the underlying illness and these patients have a higher mortality due to the severity of overall clinical status. In present article we report a case of acute subdural hematoma who developed progressive thrombocytopenia resulting in fatal outcome. A 75 year gentleman presented with history of sudden onset headache and lapsed into altered sensorium. There was history of trivial fall before he developed headache. The patient was deeply comatose with pupils bilateral 2 mm and reacting to light. Computerized tomography (CT) scan brain showed large right fronto-temporo-parietal acute subdural hematoma with mass effect and midline shift. Post-operatively he was kept on elective ventilation. On following days the patient continues to develop thrombocytopenia (Day- 3 Platelet count 75,000, day-4 60,000, day-5 25,000). Thrombocytopenia is a common but a potentially life-threatening condition problem and has been considered to play a role in worsening the prognosis of critically ill patients in intensive care unit. Few studies statistically examine the strength of the association between risk factors and outcomes related to thrombocytopenia, additional research is recommended to identify putative molecular determinants.