Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage.

Autor: Evim MS; Division of Pediatric Hematology, Uludag University Faculty of Medicine, Bursa, Turkey., Ünüvar A; Division of Pediatric Hematology and Oncology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey., Albayrak C; Division of Pediatric Hematology and Oncology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey., Zengin E; Division of Pediatric Hematology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey., Yılmaz E; Division of Pediatric Hematology and Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey., Kaya Z; Division of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey., Karadaş N; Division of Pediatric Hematology, Ege University Faculty of Medicine, İzmir, Turkey., Ertekin M; Division of Pediatric Hematology, Bakırçay University, Çiğli Training and Research Hospital, İzmir, Turkey., Üzel H; Division of Pediatric Hematology and Oncology, Dicle University Faculty of Medicine, Diyarbakır, Turkey., Özdemir GN; Division of Pediatric Hematology, İstinye University Faculty of Medicine, İstanbul, Turkey., Albayrak D; Division of Pediatric Hematology and Oncology, Medicalpark Samsun Hospital, Samsun, Turkey., Küpesiz FT; Division of Pediatric Hematology and Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey., Bahadır A; Division of Pediatric Hematology and Oncology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey., Tokgöz H; Division of Pediatric Hematology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey., Karaman K; Division of Pediatric Hematology, Van 100.yıl University Faculty of Medicine, Van, Turkey., Yılmaz B; Division of Pediatric Hematology and Oncology, Marmara University Faculty of Medicine, İstanbul, Turkey., Akbayram S; Division of Pediatric Hematology and Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey., Güneş BT; Division of Pediatric Hematology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey., Apak BB; Division of Pediatric Hematology and Oncology, Başkent University Faculty of Medicine, Ankara, Turkey., Acıpayam C; Division of Pediatric Hematology and Oncology, Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey., Aral YZ; Division of Pediatric Hematology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey., Karaman S; Division of Pediatric Hematology and Oncology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey., Ören H; Division of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Jazyk: angličtina
Zdroj: Research and practice in thrombosis and haemostasis [Res Pract Thromb Haemost] 2024 Oct 29; Vol. 8 (8), pp. 102607. Date of Electronic Publication: 2024 Oct 29 (Print Publication: 2024).
DOI: 10.1016/j.rpth.2024.102607
Abstrakt: Background: Intracranial hemorrhage (ICH) is reportedly rare but has high morbidity and mortality risk in persons with hemophilia. Although the risk factors that facilitate bleeding are known, the factors affecting the sequelae are not well known.
Objectives: We planned to investigate the risk factors for neurologic sequelae in children and adolescents with hemophilia suffering from ICH.
Methods: An invitation was sent to pediatric hematology centers via email. Clinical and laboratory findings, neurologic sequelae, and recurrence of bleeding in persons with hemophilia who developed ICH were questioned.
Results: Eighty-six patients from 21 centers were evaluated. All patients were less than 18 years of age at the time of ICH. Thirteen patients had ICH in the neonatal period, while 40 patients had a known diagnosis of hemophilia before ICH, and 33 patients were undiagnosed before ICH. Five patients died, 2 of whom died in the neonatal period. The rate of neurologic sequelae was 25 of 81 (30%). The most common neurologic sequela was epilepsy ( n  = 11/25), followed by hemiparesis ( n  = 5/25). Cerebral shift (odds ratio, 3.48) and development of ICH in the neonatal period (odds ratio, 4.67) were significant for the development of neurologic sequelae in multivariate analysis. On follow-up, recurrence of ICH occurred in 8 of 81 (10%).
Conclusion: ICH in the neonatal period and cerebral shift were the two main risk factors for the development of neurologic sequelae. Neonatal departments must be alert to the signs of bleeding. It is important for healthcare professionals to overcome the barriers to primary prophylaxis and to take trauma-related precautions.
(© 2024 The Author(s).)
Databáze: MEDLINE
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