Management of intracranial hemorrhage in a child with a left ventricular assist device.
Pediatr Transplant
; 16(5): E135-9, 2012 Aug.
Article
en En
| MEDLINE
| ID: mdl-22332723
ABSTRACT
Pediatric patients bridged to heart transplant with LVADs require chronic anticoagulation and are at increased risk of hemorrhagic complications, including intracranial hemorrhage. In this population, intracranial hemorrhage is often fatal. We report a case of successful management of a five-yr-old-boy with DCM on an LVAD who developed a subdural hematoma. We initially chose medical management, weighing the patient's high risk of thromboembolism from anticoagulation reversal against the risk of his chronic subdural hematoma. When head CT showed expansion of the hemorrhage with increasing midline shift, we chose prompt surgical evacuation of the hematoma with partial reversal of anticoagulation, given the increased risk of acute deterioration. The patient ultimately received an orthotopic heart transplant and was discharged with no permanent neurological complications. This represents a case of a pediatric patient on an LVAD who survived a potentially fatal subdural hematoma and was successfully bridged to cardiac transplantation.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Corazón Auxiliar
/
Hematoma Subdural Crónico
/
Insuficiencia Cardíaca
/
Anticoagulantes
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Child, preschool
/
Humans
/
Male
Idioma:
En
Revista:
Pediatr Transplant
Asunto de la revista:
PEDIATRIA
/
TRANSPLANTE
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos