Chronic subdural hematoma in patients with idiopathic thrombocytopenic purpura: A case report and review of the literature

Surg Neurol. 2006 Oct;66(4):411-4; discussion 414. doi: 10.1016/j.surneu.2005.12.025. Epub 2006 Jul 21.

Abstract

Background: cSDH is a rare form of bleeding in patients with ITP. Intracerebral hematoma or subarachnoid hemorrhage is more frequently reported in these patients. Spontaneous resolution of cSDH in patients with idiopathic subdural hematoma is uncommon.

Case description: We report a case of spontaneous cSDH in a patient with ITP, and we review the related cases in the literature. In our patient, the hematoma resolved spontaneously despite very low platelet levels. There also was an incidental left parietal convexity meningioma. A review of the literature is presented, and the management of the patients is discussed.

Conclusion: In patients with ITP, cSDHs may resolve spontaneously or with medical treatment, and surgery might be deferred except in emergency conditions or in patients with normal neurological findings. Close neurological and radiological observation along with the medical treatment may be appropriate in the management of patients with normal neurological findings.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain / blood supply
  • Brain / pathology
  • Brain / physiopathology
  • Cerebral Veins / pathology*
  • Cerebral Veins / physiopathology*
  • Child
  • Disease Progression
  • Female
  • Glucocorticoids / therapeutic use
  • Headache / diagnosis
  • Headache / etiology
  • Headache / physiopathology
  • Hematoma, Subdural, Chronic / diagnosis
  • Hematoma, Subdural, Chronic / etiology*
  • Hematoma, Subdural, Chronic / physiopathology
  • Humans
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / complications
  • Meningeal Neoplasms / diagnosis*
  • Meningioma / complications
  • Meningioma / diagnosis*
  • Middle Aged
  • Platelet Count
  • Prednisone / therapeutic use
  • Purpura, Thrombocytopenic, Idiopathic / complications*
  • Purpura, Thrombocytopenic, Idiopathic / physiopathology
  • Remission, Spontaneous

Substances

  • Glucocorticoids
  • Prednisone