Abstract
Intracerebral hemorrhage (ICH) is a rare and fatal complication of immune thrombocytopenia.
ICH is more common in children than in the adult population. A 30-year-old male patient,
a known case of immune thrombocytopenia, presented with sudden onset severe headache
and vomiting. Computed tomography scan showed a large right frontal intracerebral
hematoma. His platelet counts were low, and he received multiple transfusions. Though
he was initially conscious, his neurological condition progressively deteriorated,
so the decision was taken for an emergency craniotomy. Despite multiple transfusions,
his platelet counts were 10,000/µL, so craniotomy was very risky. He underwent an
emergency splenectomy and received one unit of single donor platelets. Subsequently,
his platelets count increased a few hours after, and he underwent successful evacuation
of intracerebral hematoma. He eventually had an excellent neurological outcome. Though
intracranial hemorrhage carries significant morbidity and mortality, a timely decision
of emergency splenectomy followed by craniotomy can result in an excellent clinical
outcome.
Keywords
intra cerebral hemorrhage - ITP - craniotomy - splenectomy