Successful conservative treatment of traumatic subacute subdural haematomas in neonates with haemophilia A.

ABSTRACT

PURPOSE: The aim of this report is to enlighten the role of an early diagnosis and treatment of haemophilia A during the management of an intracranial haemorrhage as well as to discuss the efficiency of a subdural transcoronal puncture compared to a craniectomy as surgical treatment of the haematoma. BACKGROUND: Haemophilia A constitutes a well-known risk factor for intracranial bleeding. However, it has been rarely described as a cause of subdural haematoma in neonates. Management of subdural haematomas in haemophilic patients is still debated. MATERIALS AND METHODS: We report two cases of infants with subacute subdural haematoma. The first of them had a familial history of haemophilia A. In the second subject, the diagnosis was obtained during the etiological workup of an intracranial haematoma. Both infants were successfully treated with transcoronal puncture of the subacute component of the haematoma and factor VIII infusion. CONCLUSIONS: Transcranial punctures associated to infusion of factor VIII should be considered an alternative surgical option in the management of subdural haematomas in neonates with haemophilia A.