Korean J Neurotrauma.  2017 Apr;13(1):57-60. 10.13004/kjnt.2017.13.1.57.

Spontaneous Acute Subdural Hemorrhage in a Patient with a Tick Borne Bunyavirus-Induced Severe Fever with Thrombocytopenia Syndrome

• Yoo J
• Oh JW
• Jang CG
• Moon JH
• Kim EH
• Chang JH
• Kim SH
• Kang SG

• KMID: 2378253
• DOI: http://doi.org/10.13004/kjnt.2017.13.1.57

Abstract

We report the first case of severe fever with thrombocytopenia syndrome (SFTS) and a spontaneous acute subdural hematoma (SDH) in Korea. A 79-year-old male presented with fever and thrombocytopenia. On the third day of hospitalization, his mental changed from drowsy to semi-coma. Brain computed tomography indicated an acute subdural hemorrhage on the right convexity. He was given early decompressive craniectomy, but did not survive. Real-time reverse transcription polymerase chain reaction analysis of a blood sample indicated the presence of SFTS virus (SFTSV). This is the first reported case with intracranial hemorrhage and SFTS. This case report describes our treatment of a patient with acute SDH and an infection from a tick-borne species of Bunyaviridae.

Keyword

Severe fever with thrombocytopenia syndrome; Bunyavirus; Subdural hematoma; Acute; Thrombocytopenia

MeSH Terms

Aged
Brain
Bunyaviridae
Decompressive Craniectomy
Fever*
Hematoma, Subdural*
Hematoma, Subdural, Acute
Hospitalization
Humans
Intracranial Hemorrhages
Korea
Male
Orthobunyavirus
Polymerase Chain Reaction
Reverse Transcription
Thrombocytopenia*
Ticks*

Figure

• 

  FIGURE 1 (A) Initial computed tomography (CT) scan taken in the emergency room upon admission to our hospital, indicating no abnormal findings. (B) Preoperative CT scan (day 3 after admission to our hospital) indicating a massive acute subdural hematoma on the right cerebral convexity with effacement of sulci markings (white arrow) and a midline shift (black arrow). (C) Postoperative CT scan showing intracerebral hemorrhage (white arrow) and devastating brain swelling.

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