Publication:

Nonoperative management of spontaneous epidural hematoma in hemophilia A

Background Spontaneous epidural haematoma is a rare clinical presentation and may be associated with coagulation disorders. These hematomas present usually with rapidly developing paraparesis and any delay in diagnosis may be disastrous.

Methods We included five patients of spontaneous epidural hematomas in hemophilia A with neurological deficit. They were treated non-operatively with factor VIII replacement therapy with oral tranexamic acid and intravenous dexamethasone as per protocol. All patients were followed up for 6 months and assessed for signs of neurological recovery and radiological resolution of hematoma.

Results All patients had complete motor recovery within 3 months of initiating treatment and showed resolution of hematoma on MRI.

Conclusions Prognosis following early initiation of correction of factor deficiency is good.