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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(02): 391-395
DOI: 10.1055/s-0043-1769891
Case Report

Life-Threatening Intracerebral Hemorrhage in Adult with ITP: Challenging Entity

Batuk Diyora
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, Maharashtra, India
,
Anup Purandare
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, Maharashtra, India
,
Kavin Devani
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, Maharashtra, India
,
Pramod Kale
2   Department of Anaesthesia, Zen Hospital and Research Center, Chembur, Mumbai, Maharashtra, India
,
Vikrant Shah
3   Department of Medicine, Zen Hospital and Research Center, Chembur, Mumbai, Maharashtra, India
,
Roy Patankar
4   Department of Surgery, Zen Hospital and Research Center, Chembur, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Intracerebral hemorrhage (ICH) is a rare and fatal complication of immune thrombocytopenia. ICH is more common in children than in the adult population. A 30-year-old male patient, a known case of immune thrombocytopenia, presented with sudden onset severe headache and vomiting. Computed tomography scan showed a large right frontal intracerebral hematoma. His platelet counts were low, and he received multiple transfusions. Though he was initially conscious, his neurological condition progressively deteriorated, so the decision was taken for an emergency craniotomy. Despite multiple transfusions, his platelet counts were 10,000/µL, so craniotomy was very risky. He underwent an emergency splenectomy and received one unit of single donor platelets. Subsequently, his platelets count increased a few hours after, and he underwent successful evacuation of intracerebral hematoma. He eventually had an excellent neurological outcome. Though intracranial hemorrhage carries significant morbidity and mortality, a timely decision of emergency splenectomy followed by craniotomy can result in an excellent clinical outcome.

Keywords

intra cerebral hemorrhage - ITP - craniotomy - splenectomy

Note

This work should be attributed to L.T.M. Medical College and Sion General hospital, Mumbai, India.




Publication History

Article published online:
16 June 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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