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Article
October 1984

Head Trauma in HemophiliaA Prospective Study

Author Affiliations

From the Louisiana Comprehensive Hemophilia Care Center, Section of Hematology and Medical Oncology, Department of Medicine, Tulane University School of Medicine (Dr Andes and Ms Wulff) and the Ochsner Foundation Hospital (Dr Smith), New Orleans.

Arch Intern Med. 1984;144(10):1981-1983. doi:10.1001/archinte.1984.04400010093017
Abstract

• Intracranial hemorrhage (ICH) remains a serious problem in hemophilia. Consecutive episodes of ICH or reports of head trauma were prospectively recorded in 140 patients with hemophilia seen during a two-year period. Forty of 48 consecutive episodes of ICH or trauma occurred in 37 patients with severe disease (<1% factor VIII or IX). Five injured patients had inhibitors to factor VIII. Two fatalities occurred following injury and one patient died following a spontaneous bleed. Injury in 40 instances warranted replacement therapy. No patient given coagulation factor within six hours of injury experienced ICH. The risk of ICH following head trauma (13% in this series) warrants aggressive use of coagulation factor replacement. Watchfulness in dealing with such patients and early therapy may be more necessary than often realized.

(Arch Intern Med 1984;144:1981-1983)

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