J Neurocrit Care.  2017 Dec;10(2):126-128. 10.18700/jnc.170025.

Glanzmann Thrombasthenia in a Korean Patient: A Postoperative Intracranial Hemorrhagic Diasthesis in a Patient with a Rupture of a Cerebral Aneurysm

• Choi MS
• Lee JH
• Lim YC

• KMID: 2405769
• DOI: http://doi.org/10.18700/jnc.170025

Abstract

BACKGROUND
Glanzmann thrombasthenia (GT) is a rare disease with severe insufficiency of platelet function. There are no reports of GT associated with a cerebral hemorrhage.
CASE REPORT
A 45-year-old woman had a stuporous mentality. Her computed tomographic (CT) angiography revealed a rupture of the posterior cerebral artery aneurysm. Hunt-Hess grade was 4 points and Fisher grade was 3 points. A clipping of the aneurysm was performed and proceeded to external ventricular drainage for hydrocephalus after 6 days. But, a new hemorrhage was detected several times via a follow-up brain CT. Various blood tests were conducted to evaluate the bleeding tendency, and the GT was diagnosed with PFA-200. The ventriculoperitoneal shunt was performed after the platelets transfusion, and she was discharged without other complications.
CONCLUSION
With nonspecific and recurrent intracranial hemorrhage, a GT should be included in the differential diagnosis, which is important in controlling bleeding during the surgery.

Keyword

Trombastniahe; Postoperative hemorrhages; Aneurysm, Ruptured

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Angiography
Blood Platelets
Brain
Cerebral Hemorrhage
Diagnosis, Differential
Drainage
Female
Follow-Up Studies
Hematologic Tests
Hemorrhage
Humans
Hydrocephalus
Intracranial Aneurysm*
Intracranial Hemorrhages
Middle Aged
Postoperative Hemorrhage
Rare Diseases
Rupture*
Stupor
Thrombasthenia*
Ventriculoperitoneal Shunt

Figure

• 

  Figure 1. Brain computed tomography finding shows the status of the clipping of an aneurysm and inserting an intraoperative external ventricular drainage catheter (A, B). A new hemorrhage was observed at the removal site of the existing catheter in the right side and at the insertion site of the new catheter in the left side (C). The expansion of the hemorrhage around catheter in the left side was detected (D).

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