Bilateral Subdural Hematomas in an Adult With Hereditary Factor VII Deficiency: A Complication of Sit-ups and Inversion?

Barton, James C.; Bertoli, Luigi F.; O’Malley, Sean M.

doi:10.1177/1076029607308862

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Although, various CFs including CFVII, CFX, and CFXI could lead to intractable CSH,[ 3 9 20 ] in the present study, we focused on the clinical value of CFXIII activity since the intravenous administration of CFXIII accelerates healing of CSF leak sites from the perspective of CSFH treatment. [ 14 ] We retrospectively analyzed whether low CFXIII activity was involved in the development of CSH and in the exacerbation of CSH after treatment in patient with CSFH-associated CSH.…”

Section: Introductionmentioning

confidence: 99%

Impact of low coagulation factor XIII activity in patients with chronic subdural hematoma associated with cerebrospinal fluid hypovolemia: A retrospective study

Shimogawa¹,

Morioka²,

Sayama³

et al. 2017

Surg Neurol Int

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Background:Cerebrospinal fluid hypovolemia (CSFH) is sometimes associated with chronic subdural hematomas (CSHs). Affected patients often develop enlargement and recurrence of the CSH, even if appropriate treatments such as epidural blood patch (EBP) and/or burr-hole surgery for the CSH are performed. This situation may lead to subclinical coagulopathy, including low coagulation factor XIII (CFXIII) activity. We retrospectively analyzed whether CFXIII activity was involved in the development of CSHs and post-treatment exacerbation of CSHs in patients with CSFH.Methods:We diagnosed CSFH by radioisotope (RI), magnetic resonance imaging (MRI) and computed tomography (CT) findings, and CSH by CT and/or MRI findings. The plasma CFXIII activity was assessed on admission. All patients with CSFH initially received conservative treatments. When these treatments were ineffective, the patients underwent EBP and/or CSH surgery according to previously reported therapeutic strategies.Results:Among 206 patients with CSFH, 19 developed CSHs. Fourteen patients with a thin hematoma underwent EBP and three with a thick hematoma underwent CSH surgery immediately after EBP on the same day. We were unable to diagnose two patients with CSFH at the time of admission, and one of these two patients underwent repeated CSH surgery before obtaining the correct diagnosis. Seven patients (36.8%) developed CSH exacerbation after the treatment. The CFXIII activity was significantly lower in patients with than without a CSH (42.1% vs. 12.8%, respectively; P = 0.003). The CFXIII activity was significantly lower in patients with than without post-treatment CSH exacerbation (P = 0.046). All five patients with low CFXIII activity who developed CSH exacerbation received intravenous injection of CFXIII and had no recurrence of CSH after the additional treatment.Conclusion:In patients with CSFH, low CFXIII activity is one of the risk factors for both the development of a CSH and the post-treatment exacerbation CSH.

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