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Extensive epidural hematoma in a 7 month old boy with hemophilia 2007

Jonathan Morris, MD
Peter Kalina, MD, Non ASSR Member
Corey Raffel, MD, PhD, Non ASSR Member

Excerpta Extraordinaire

Excerpta

A 7 month old boy presented with irritability, refusal to crawl and loss of neck control. MRI revealed a C2 to L4 partially enhancing spinal epidural hematoma (SEH) with cord compression. There was no trauma history. A PTT of 79 precluded a CT guided biopsy (to help exclude other etiologies of spinal epidural lesions in children). Factor VIII was found to be less than 0.01 U/ml. As a result of the MRI and laboratory data, the boy was able to be diagnosed with severe hemophilia A. He improved following aggresive Factor VIII replacement therapy.
Non-traumatic SEH is a rare complication of hemophilia. Complete neurological recovery is possible after replacement therapy, without the need for an extensive surgical decompression.

References

Jonathan Morris, MD