PB1212 - Intracranial hemorrhage and management in patients with hemophilia: The experience of Çukurova

Background: Intracranial hemorrhage (ICH) is a life threatening complication of hemophilia in childhood resulting in high rates of mortality and disabling sequelae.

Aims: In this study, we evaluated our hemophilia patients with intracranial hemorrhage and compared with literature.

Methods: From 1995 to 2024 our hemophilia patients with intracranial hemorrhage were diagnosed and evaluated in Cukurova region of Turkey in three centers. ICH episodes, the findings of physical examination, CT scan or MRI and treatment strategies including surgical interventions were reviewed retrospectively.

Results: We evaluated 43 episodes of ICH from 37 patients with hemophilia (CFD). Age range was from 9 days to 24 years. There were 34 patients with hemophilia A, 3 patients with hemophilia B. Except six patients, all patients had one bleeding episode. Five patients had a high titer inhibitor against factor VIII. The most important factor was trauma. A history of recent trauma was documented in 28 patients. Intracerebral and subdural hematoma were more frequently seen. The most frequent symptoms were seizure and headache. The diagnosis of hemophilia was established in five patients after intracranial hemorrhage who referred to our center with ICH. In seven patients, hematoma was evacuated. Five hemophilia patients died due to ICH and three patients presented late sequelae.

Conclusion(s): Intracranial hemorrhage is the most serious complication in childhood, especially for hemophilia. Urgent establishing diagnosis and treatment with prompt doses of factors to initially maintain a normal concentration of circulating factor is mandatory. Despite the prompt treatment, death and late sequelae can be seen in this patients group.