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Subacute Spinal Subdural Hematoma in One-Year Old Boy Due to Severe Hemophilia A

Faculty of Medicine, Universitas Diponegoro, Indonesia

Received: 28 Oct 2021; Revised: 20 Dec 2021; Accepted: 29 Dec 2021; Available online: 31 Dec 2021; Published: 31 Dec 2021.
Open Access Copyright (c) 2021 Journal of Biomedicine and Translational Research
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Paraparesis may result from a variety of or primary central nervous system conditions or systemic disorders, and although rare, it may also caused by spinal cord hemorrhage. Spontaneous spinal subdural hematomas (SSDH) are most frequently associated with coagulopathies. People with congenital clotting disorders such as hemophilia are at increased risk for experiencing spontaneous spinal subdural hemorrhage at unusual sites, which is a rare case and a neurological emergency required urgent recognition. We report a boy with paraparesis caused by subacute SSDH due to hemophilia A. 

Case Presentation: A 15 month-old boy, with chief complain of difficulty in moving his leg and pain when walking, physical examination revealed a lower motor neuron lesion, laboratory showed a low factor VIII at 0.4% level, Magnetic Resonance Imaging (MRI) showed anterior and posterior displacement of the spinal cord due to the presence of the subacute subdural hematoma extending from 1st cervical to 1st lumbar spine. He assessed with inferior paraparesis caused by subacute spinal subdural hematoma due to hemophilia A. The patient’s condition was improved after received replacement therapy of factor VIII and proper laminectomy neurosurgery. 

Conclusion: This case showed an approach for a comprehensive diagnostic and management for a rare case of paraparesis due to hemophilia. Pay attention to the physical examination which shows a lower motor neuron lesion in an acute paralysis cases, there is still a possibility that it is an upper motor neuron lesion. 

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Subacute spinal subdural hematoma in one year old boy due to severe hemophilia A: A case report
Subject paraparesis inferior; hemophilia A; spinal subdural hematoma; factor VIII
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 Research Instrument
Subacute spinal subdural hematoma in one year old boy due to severe hemophilia A: A case report
Subject paraparesis inferior; hemophilia A; spinal subdural hematoma; factor VIII
Type Research Instrument
  View (58KB)    Indexing metadata
 common.other
Figure 1. MRI of whole spine sagittal T1-weighted image and T2-weighted image revealed a subacute subdural hematoma extending from C1 to T9 on anterior aspect, then T10 to L1 on posterior aspect.
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Figure 2. MRI images of an axial section T1-weighted image and T2-weighted image at the T11 level also showed a displacement of the spinal cord to anterior due to the hematoma.
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Subacute spinal subdural hematoma in one year old boy due to severe hemophilia A: A case report
Subject
Type Other
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 common.other
Subacute spinal subdural hematoma in one year old boy due to severe hemophilia A: A case report
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Keywords: paraparesis inferior; hemophilia A; spinal subdural hematoma; factor VIII

Article Metrics:

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