A 2-Year-Old With Intracranial Hemorrhage

Authors: Jamie Hixon, MD; Stefanos Intzes, MD; Gautam Malkani, MD Series Editor: Sheryl A. Falkos, MD; Rosa A. Vidal, MD


August 07, 2006


A 2-year-old black male, with a past medical history significant for sickle cell anemia (Hb SS) and hemophilia B, presented as a transport to the pediatric intensive care unit (PICU) from an outlying hospital secondary to altered mental status. Symptoms of lethargy and decreased activity began approximately 1 day prior to admission. The mother reported difficulty in arousing the patient on the day of admission. The patient also began to have symptoms of nausea and vomiting on the day of admission. Review of symptoms was negative for fever, chills, trauma, injury, and recent ingestions or medications.

Past medical history: Hb SS, hemophilia B, history of hemarthrosis, previously treated with factor IX

Family history: Brother and maternal grandfather with hemophilia

A CT scan of the brain was done following initial presentation. The scan revealed a left frontal intraparenchymal and a left temporal hemorrhage, with a 1-cm right shift. There was also effacement of the left lateral ventricle and the third ventricle. Patient was intubated and transported to the PICU for further care.


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