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Case Report
Management of Spontaneous Spinal Epidural Hematoma Developed in Children with Hemophilia
Clin Pediatr Hematol Oncol 2018;25:180-4.
Published online October 31, 2018
© 2018 Korean Society of Pediatric Hematology-Oncology and Korean Society for Pediatric Neuro-Oncology

Han Na Jang, M.D., Hoi Soo Yoon, M.D., Ph.D. and Young Shil Park, M.D., Ph.D.

Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence to: Young Shil Park
Department of Pediatrics, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel: +82-2-440-6133
Fax: +82-2-440-7175
E-mail: pysmd@khnmc.or.kr
ORCID ID: orcid.org/0000-0002-6643-4245
Received August 29, 2018; Revised September 13, 2018; Accepted September 30, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Spinal epidural hematoma (SEH) is a rare neurosurgical emergency in which pressure on the spinal cord leads to acute neurological deficits, and is a rare complication in children with hemophilia. We report three cases of SEH in severe hemophilia A. An 8-month-old boy who presented with non-traumatic acute-onset irritability was found to have SEH and was later diagnosed with hemophilia. The two other patients presented with neck pain and magnetic resonance imaging confirmed the diagnosis of SEH. Two patients who received conservative management fully recovered, however the patient who presented with progressive neurological abnormalities at the time of diagnosis, received surgery but later developed breathing difficulties and quadriplegia. Early diagnosis and immediate, aggressive, clotting factor replacement therapy are crucial when managing SEH in children with hemophilia. Immediate and aggressive factor replacement, accompanied by both neurological monitoring and early imaging, are essential for hemophiliac with suspected SEH.
Keywords: Hemophilia, Spinal, Epidural, Hematoma, Management


October 2018, 25 (2)
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  • Young Shil Park