Management of intracerebral hemorrhage in idiopathic thrombocytopenic purpura

Abstract

There has been little comment on the specific management of intracerebral bleeding occurring in patients suffering idiopathic thrombocytopenic purpura. Cases of 4 children with intracerebral hemorrhage due to this coagulation disturbance are described. A management plan is described based on this experience; it includes immediate control of cerebral edema, emergency splenectomy, supportive care with platelet transfusions and corticosteroids, cerebral angiography and a definitive neurosurgical procedure. Radiological investigation and surgical therapy could be performed with a single general anesthetic when necessary. Three of the patients survived without major neurological sequelae.