J Korean Neurosurg Soc.  2004 Oct;36(4):302-305.

Intracranial Hemorrhage in Patients with Hematologic Disorders

• Choi YJ
• Rha HK
• Park HK
• Lee KJ
• Joo WI
• Kim MC

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.

Keyword

Hematologic disorder; Intracranial hemorrhage; Thrombocytopenia; Leukocytosis; Disseminated intravascular coagulopathy

MeSH Terms

Anemia, Aplastic
Brain
Cause of Death
Cerebral Hemorrhage
Granulocyte Precursor Cells
Hematologic Diseases
Hematology
Hematoma
Hematoma, Subdural
Hemorrhage
Humans
Intracranial Hemorrhages*
Leukemia
Leukemia, Myeloid, Acute
Leukocytosis
Multiple Myeloma
Myelodysplastic Syndromes
Polycythemia Vera
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Risk Factors
Subarachnoid Hemorrhage
Thrombocytopenia