Intracranial Hemorrhage in Patients with Hematologic Disorders.

Choi, Young Jun; Rha, Hyung Kyun; Park, Hae Kwan; Lee, Kyung Jin; Joo, Won Il; Kim, Moon Chan

Original Article

Journal of Korean Neurosurgical Society 2004;36(4): 302-305.

Young Jun Choi, Hyung Kyun Rha, Hae Kwan Park, Kyung Jin Lee, Won Il Joo, Moon Chan Kim

Department of Neurosurgery, The Catholic University of Korea, Catholic Neuroscience Center, Seoul, Korea. jwi@catholic.ac.kr

ABSTRACT

OBJECTIVE
Spontaneous intracranial hemorrhage is still common cause of death in the hematologic disorder including leukemia. The authors examine laboratory & radiological findings in patients with intracranial hemorrhage caused by hematologic disorder. METHODS: From March 1998 to May 2002, 42 patients with hematologic disease complicated by intracranial hemorrhage were transferred from hematology department. The patients were normotensive and had not trauma history. In all patients, intracranial hemorrhages were diagnosed with the brain computerized tomography. Surgical treatment was performed in one case. RESULTS: Underlying hematologic disorders included aplastic anemia (4), acute myeloblastic leukemia (20), acute lymphoblastic leukemia (6), chronic myeloblastic leukemia (8), myelodysplastic syndrome (2), multiple myeloma (1), and polycythemia vera (1). Intracranial hemorrhage subtypes consisted of intracerebral hemorrhage (39) including mainly subcortical lobar hemorrhage (28), and subarachnoid hemorrhage (3). Twenty (48%) of the 42 patients had multifocal hematomas. Thirty six patients (86%) had moderate and severe thrombocytopenia (less than 100x10(9)/L). Twenty four patients (57%) had moderate and severe leukocytosis (greater than 20x109/L). CONCLUSION: It showed that (1) the risk factors of intracranial hemorrhage in hematologic disorders are thrombocytopenia, leukocytosis and disseminated intravascular coagulopathy ; (2) intracerebral hemorrhage in hematologic disorders occur preferentially in the subcortical portion ; (3) intracranial hemorrhage in hematologic disorders consist of various combinations of subcortical lobar hemorrhage, subarachnoid hemorrhage, subdural hemorrhage and intraventricular hemorrhage ; (4) intracerebral hemorrhage in hematologic disorders tend to be multiple.

Key Words: Hematologic disorder; Intracranial hemorrhage; Thrombocytopenia; Leukocytosis; Disseminated intravascular coagulopathy