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P108/262  Surgical management of spontaneous intracerebral hematoma in a patient with hemophilia C(XI factor deficiency)
  1. Hayk Harutyunyan,
  2. Sevak Badalyan,
  3. Ruben Fanarjyan,
  4. Gurgen Melkumyan,
  5. Ruzan Nazinyan
  1. Yerevan State Medical University, Neurological Surgery, Yerevan, Armenia


Introduction Hemophilia C (HC) is a rare, inherited bleeding disorder when the blood does not clot properly. In patient with Hemophilia C there is deficiency of factor XI. Spontaneous intracerebral hemorrhage is a rare and challenging condition to treat, especially in hemophiliacs.

Aim of Study To study the surgical result of patient with Hemophilia C.

Methods A 28-year-old man, was taken to our hospital with sudden onset of headache. Complaints were available for 2 days without history of trauma. The patient had history of hemophilia C. The computed tomography (CT) scan revealed subcortical hemorrhage of the right temporal lobe. His GCS at admission was 15. The patient had no neurological deficit. An urgent consultation with the treating hematologist was performed, and a decision was made to manage the patient conservatively (fresh frozen plasma (FFP) 4 units, mannitol 10% 1000 mg, tranexamic acid 1000mg). 10 hours after admission, his GCS and CT scan of the brain were unchanged. 36 hours after admission, the neurological status of the patient was worsened. His GCS dropped to 12.

Results A decision was made to immediately perform a temporal craniotomy with evacuation of intracerebral hematoma. Surgery and the postoperative period were uneventful. The following 2 days he received 4 units of FFP, tranexamic acid 1000mg and mannitol 10% 1000 mg/day.

Conclusion Spontaneous intracranial hemorrhage is a serious and potentially fatal sequela of Hemophilia. Correction of clotting factor deficiency is of paramount importance prior to surgery and in the immediate post-operative period.

Disclosure of Interest Nothing to disclose

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