Spinal epidural haematoma in haemophilia A with inhibitors – efficacy of recombinant factor VIIa concentrate

Leach, Michael J.; Makris, Mike; Hampton, K. K.; Preston, F. E.

doi:10.1046/j.1365-2516.1999.00301.x

Cited by 19 publications

(9 citation statements)

References 11 publications

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“…The etiology of SSEH is generally unknown. Some predisposing factors include anticoagulant therapy [4], vascular malformation [5], hemophilia [6] and cocaine abuse [7], all suggested to be correlated with SSEH.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous cervical epidural hematoma during pregnancy: case report and literature review

et al. 2010

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Spontaneous spinal epidural hematoma (SSEH) during pregnancy is rare and may result in permanent damage if not promptly treated. There were few studies discussing the etiology, presentation and treatment of SSEH during pregnancy. The authors describe a case of spontaneous cervical epidural hematoma during pregnancy, which was diagnosed by magnetic resonance imaging (MRI) and managed with surgical evacuation. A retrospective review of a case of spontaneous epidural hematoma of spine during pregnancy was performed. The clinical features, diagnoses, treatments and outcomes of all cases were analyzed. Precise diagnosis without delay and rapid surgical treatment are essential for the management of SSEH during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Spontaneous cervical epidural hematoma during pregnancy: case report and literature review

et al. 2010

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“…2 Only a few reports have described SEHs in hemophiliac children with inhibitors. Leach et al 3 successfully treated a 21-year-old man with severe hemophilia A and inhibitors who presented with an extensive SEH using recombinant activated factor VIIa. Oymak et al 4 also successfully treated an infant with severe hemophilia A and inhibitors who presented with an SEH using recombinant activated factor VIIa.…”

Section: Discussionmentioning

confidence: 99%

Conservative therapy for spinal epidural hematoma in a child with hemophilia A with high-titer VIII inhibitors

Wang

2021

J Int Med Res

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The occurrence of a spinal epidural hematoma in patients with hemophilia A with high-titer VIII inhibitors is extremely rare and intractable. A 15-year-old male patient presented to our institution with acute back pain and progressive sensorimotor disorder of the bilateral lower extremities. He had hemophilia A with high-titer VIII inhibitors and had experienced recurrent hemorrhagic episodes for many years. Prompt magnetic resonance imaging revealed a spinal epidural hematoma. We administered bypassing agent therapy with prothrombin complex concentrates and performed intensive neurological monitoring. The neurological dysfunction improved with days, and the patient recovered completely within 3 weeks. Magnetic resonance imaging 1 year later showed that the hematoma had been completely absorbed. Spinal epidural hematomas in patients with hemophilia A with high-titer inhibitors can be successfully treated using prothrombin complex concentrates. Multidisciplinary discussions based on intensive neurological monitoring should be performed as early in the clinical course as possible.

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“…During the early stages of bleeding, absolute resting is essential and slow mobilization is recommended in the following days. Prothrombin complex concentrates (PCC), aPCC and recombinant FVIIa are alternative therapy choices in patients with inhibitor [12].…”

Section: Discussionmentioning

confidence: 99%

Spinal epidural haematoma in a patient with haemophilia B

2006

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Spinal epidural haematoma (SEH) is a rare complication in haemophiliacs. We report the case of a 17-year-old boy with severe haemophilia B who presented with acute onset of neck/back pain, walking impairment and urinary retention because of an extensive SEH. The haematoma was identified by magnetic resonance imaging of the spinal column. Prompt and aggressive treatment with factor IX concentrate led to complete recovery at 3 weeks. This case calls attention to the clinical manifestation, radiological features and management options of the rarely reported SEH in haemophiliacs. Despite evidence of extensive SEH, factor replacement therapy and a multidisciplinary team approach result in complete neurological recovery without the need for surgical decompression.

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Spinal epidural haematoma in haemophilia A with inhibitors – efficacy of recombinant factor VIIa concentrate

Cited by 19 publications

References 11 publications

Spontaneous cervical epidural hematoma during pregnancy: case report and literature review

Spontaneous cervical epidural hematoma during pregnancy: case report and literature review

Conservative therapy for spinal epidural hematoma in a child with hemophilia A with high-titer VIII inhibitors

Spinal epidural haematoma in a patient with haemophilia B

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