Atraumatic Spinal Epidural Hematoma as Initial Presentation of Hemophilia A in an Infant

Abstract

Hemophilia A is characterized by deficiency of factor VIII. We present a unique, illustrative case of an infant with a short history of neck pain and irritability without neurological deficits who was found to have a spinal epidural hematoma. The subsequent investigation for the etiology, including workup for nonaccidental trauma, led to a diagnosis of severe hemophilia A.

Symptomatic Cervical Spinal Cord Injury Without Accompanying Intracranial Injury Because of Child Abuse

“…8 "Spontaneous" cervical EDHs have been described both alone and accompanying clotting disorders, such as hemophilia. 8,9 Those children without coagulation disorders were variably investigated, so may include some unrecognized AHT cases. 8 Our child had abundant clinical and radiological evidence of cervical trauma and multifocal abusive injuries.…”

“…Valveless epidural venous plexuses may be the source 8 . “Spontaneous” cervical EDHs have been described both alone and accompanying clotting disorders, such as hemophilia 8,9 . Those children without coagulation disorders were variably investigated, so may include some unrecognized AHT cases 8 .…”