Spontaneous Epidural and Corpus Callosum Hemorrhage in Sickle Cell Disease – An Unusual Presentation in a Ghanaian Patient

Kotey, Solomon N; Dike, Nkechi O; Nani, Edem; Nyame, Kwaku

doi:10.7759/cureus.12292

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Spontaneous extradural hemorrhage in a patient with sickle cell disease has been described in the literature. [ 5 ] Our patient did not have any coagulopathic condition and he did not receive any anticoagulants/antiplatelets as part of treatment of mild COVID-19 pneumonia. In spite of multiple episodes of brain hemorrhages and infarct, the patient was able to recover and underwent cranioplasty at 11-month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Concurrent intracranial infarct and intraventricular hemorrhage with spontaneous nontraumatic extradural hemorrhage in follow-up: An enigma of COVID-19-associated intracranial vasculopathy

Sreenivasan

Arora

Vaishya

et al. 2022

Surgical Neurology International

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Background: Several neurological manifestations have been described in the literature, in patients affected with COVID-19 infection. Some common forms include ischemic stroke, cardioembolic stroke, intraparenchymal hemorrhage, and multicompartmental hemorrhage. Concurrent brain infarct and intraventricular hemorrhage (IVH) have not been described in the literature previously. Case Description: A 35-year hypertensive and COVID-19-positive patient developed sudden-onset spontaneous IVH with concurrent infarct in the left internal capsule. In spite of undergoing an initial CSF drainage procedure, he had persistent worsening sensorium and increasing midline shift on CT imaging, so he underwent a left-sided decompressive craniectomy. One month after discharge, he developed spontaneous extradural hemorrhage at the operative site. In view of impending cerebral herniation, emergency hematoma evacuation was done, which restored his neurological status. Conclusion: This is the first reported detailed case of concurrent intracranial infarct and IVH in a patient affected with COVID-19 infection. We also report a rare phenomenon of nontraumatic noncoagulopathic extradural hemorrhage on the decompressive craniectomy site, in this patient 1 month after surgery.

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Section: Discussionmentioning

confidence: 99%

Concurrent intracranial infarct and intraventricular hemorrhage with spontaneous nontraumatic extradural hemorrhage in follow-up: An enigma of COVID-19-associated intracranial vasculopathy

Sreenivasan

Arora

Vaishya

et al. 2022

Surgical Neurology International

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“…Other manifestations include hemiparesis or hemiplegia, and some patients present with soft scalp swellings that develop rapidly and without evidence of trauma and drop in hemoglobin which cannot be solely attributed to the crisis. [ 10 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

Spontaneous epidural hematoma

Nasiri

Takroni

Ahmed

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: Sickle cell disease (SCD) is defined as an autosomal recessive disorder characterized by the production of abnormal hemoglobin S and is correlated with high morbidity and mortality. The clinical consequences of SCD include pain crisis, acute chest syndrome, and strokes. Spontaneous epidural hematoma is a rare manifestation in sicklers with few cases reported in the literature.[ 6 ] The pathophysiology is not completely understood. However, a few explanations have been reported over the years that include vaso-occlusion of the bone resulting in bone infarction, microfracture due to rapid expansion of hematopoiesis of the inner cortex, and sludging of the sickle cells in the diploic veins—all result in leaking of blood in the epidural or in the subgalea space. Patient Concerns: A 14-year-old boy known to have SCD (Hb SS) presented to the Security Forces Hospital with a history of diffuse headache associated with nausea that started 12 h prior to presentation. Diagnosis: Computed tomography (CT) showed bilateral frontal epidural hematoma and subgaleal space. Intervention: A multidisciplinary team was created (hematology, neurology, neurosurgery, and interventional radiology) and a plan was formulated as follows: Continuous monitoring of the patient’s neuro vital signs and transfuse the patient with blood and platelets in addition with Levetiracetam. Outcomes: The patient was discharged after 9 days of hospital admission. He has remained symptom-free post-transfusion. Post-discharge CT scan showed a reduction in the hematoma size. Conclusion: A high index of suspicion is needed for a prompt diagnosis and treatment of this rare complication of SCD. The management strategy of EDH depends on the level of consciousness of the patient upon presentation. Surgical approach with craniotomy and evacuation or conservative management have been used with full recovery of the patients.

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“…If our men don't measure up to this yardstick, I would put it to ignorance on their part because of the structure of our society, it has always been the kind of society where the woman is inferior to the male." [51] This sentiment was pervasive in the interviews conducted for this research. Both male and female informants stated that women were given little respect and one informant even stating that her husband told her that she was not even intelligent enough to drive a car.…”

Section: "Con-jungle": the Geography Of Marriagementioning

confidence: 93%