Head injury with Von Willebrand’s disease

9 Oct


SMALL STUDY, but rare disease, with some food for thought on the symptoms of the ICH kids:

 

incidence of intracranial haemorrhage (ICH) in von Willebrand disease (VWD) is not well documented.

 

 

single centre case series, 33 head trauma events leading to medical attention occurred in 24 of 153 children with VWD (so some kids hit their head more than once)

15/33 events got CT’d

6/15 had an ICH

  • two of the 6 cases an ICH was only confirmed following a second CT scan (best of luck)

 

Neurological symptoms included:

  • vomiting (noted in all six),
  • headache,
  • irritability,
  • lethargy and/or alterated LOC

In contrast vomiting, irritability and altered LOC were never present in those children without confirmed ICH.

 

THEIR CONCLUSION:

ICH, although rare, does occur in children with VWD and particularly in children with type 3 VWD. A much larger cohort of patients with VWD experiencing an ICH is needed to make recommendations…

 

IF NEEDED:

Desmopressin can be administered IV, SQ, or IN.

IV dose of 0.3 micrograms/kg (maximum 20 micrograms) is diluted in 50 mL of normal saline and infused over 20 to 30 minutes; the same dose is given with subcutaneous therapy

 

Submitted by H. Reed-Day.

 

References: Haemophilia. 2013 Jul;19(4):602-6. doi: 10.1111/hae.12142. Epub 2013 Apr 5.; picture

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