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Extra-Axial Hematoma and Trimethoprim-Sulfamethoxazole Induced Aplastic Anemia: The Role of Hematological Diseases in Subdural and Epidural Hemorrhage.

Menger RP, Dossani RH, Thakur JD, Farokhi F, Morrow K, Guthikonda B - Case Rep Hematol (2015)

Bottom Line: Conclusion.Thrombocytopenia, regardless of cause, is a risk factor for the development of spontaneous subdural hematoma.Given the lack of a significant traumatic mechanism, this subset of subdural hematoma is more suitable to conservative management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, LSU Health Sciences Center-Shreveport, 1501 Kings Highway, P.O. Box 33932, Shreveport, LA 71130-3932, USA.

ABSTRACT
Objective and Importance. To illustrate the development of spontaneous subdural hematoma secondary to aplastic anemia resulting from the administration of trimethoprim-sulfamethoxazole. This is the first report of trimethoprim-sulfamethoxazole potentiating coagulopathy leading to any form of intracranial hematoma. Clinical Presentation. A 62-year-old female developed a bone marrow biopsy confirmed diagnosis of aplastic anemia secondary to administration of trimethoprim-sulfamethoxazole following a canine bite. She then developed a course of waxing and waning mental status combined with headache and balance related falls. CT imaging of the head illustrated a 3.7 cm × 6.6 mm left frontal subdural hematoma combined with a 7.0 mm × 1.7 cm left temporal epidural hematoma. Conclusion. Aplastic anemia is a rare complication of the administration of trimethoprim-sulfamethoxazole. Thrombocytopenia, regardless of cause, is a risk factor for the development of spontaneous subdural hematoma. Given the lack of a significant traumatic mechanism, this subset of subdural hematoma is more suitable to conservative management.

No MeSH data available.


Related in: MedlinePlus

Repeat axial CT head without contrast.
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fig2: Repeat axial CT head without contrast.

Mentions: Follow-up visit two days later revealed white count of 12.0, hemoglobin of 12.7, hematocrit of 37.0, and a platelet count of 117 K. She had no neurological deterioration and follow-up CT scan revealed reduction in the size of the epidural hematoma to 6.3 × 1.5 cm and the subdural hematoma to 2.5 cm × 4.4 mm (Figure 2). Final blood work was negative for HIV, hepatitis A, B, or C, bacterial infection, lupus, rheumatoid arthritis, and antiplatelet antibodies. The anemia was ultimately attributed to her trimethoprim-sulfamethoxazole use.


Extra-Axial Hematoma and Trimethoprim-Sulfamethoxazole Induced Aplastic Anemia: The Role of Hematological Diseases in Subdural and Epidural Hemorrhage.

Menger RP, Dossani RH, Thakur JD, Farokhi F, Morrow K, Guthikonda B - Case Rep Hematol (2015)

Repeat axial CT head without contrast.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493288&req=5

fig2: Repeat axial CT head without contrast.
Mentions: Follow-up visit two days later revealed white count of 12.0, hemoglobin of 12.7, hematocrit of 37.0, and a platelet count of 117 K. She had no neurological deterioration and follow-up CT scan revealed reduction in the size of the epidural hematoma to 6.3 × 1.5 cm and the subdural hematoma to 2.5 cm × 4.4 mm (Figure 2). Final blood work was negative for HIV, hepatitis A, B, or C, bacterial infection, lupus, rheumatoid arthritis, and antiplatelet antibodies. The anemia was ultimately attributed to her trimethoprim-sulfamethoxazole use.

Bottom Line: Conclusion.Thrombocytopenia, regardless of cause, is a risk factor for the development of spontaneous subdural hematoma.Given the lack of a significant traumatic mechanism, this subset of subdural hematoma is more suitable to conservative management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, LSU Health Sciences Center-Shreveport, 1501 Kings Highway, P.O. Box 33932, Shreveport, LA 71130-3932, USA.

ABSTRACT
Objective and Importance. To illustrate the development of spontaneous subdural hematoma secondary to aplastic anemia resulting from the administration of trimethoprim-sulfamethoxazole. This is the first report of trimethoprim-sulfamethoxazole potentiating coagulopathy leading to any form of intracranial hematoma. Clinical Presentation. A 62-year-old female developed a bone marrow biopsy confirmed diagnosis of aplastic anemia secondary to administration of trimethoprim-sulfamethoxazole following a canine bite. She then developed a course of waxing and waning mental status combined with headache and balance related falls. CT imaging of the head illustrated a 3.7 cm × 6.6 mm left frontal subdural hematoma combined with a 7.0 mm × 1.7 cm left temporal epidural hematoma. Conclusion. Aplastic anemia is a rare complication of the administration of trimethoprim-sulfamethoxazole. Thrombocytopenia, regardless of cause, is a risk factor for the development of spontaneous subdural hematoma. Given the lack of a significant traumatic mechanism, this subset of subdural hematoma is more suitable to conservative management.

No MeSH data available.


Related in: MedlinePlus