Spontaneous acute subdural haematoma and intracerebral haemorrhage in patient with HELLP syndrome: case report

HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome can result in a fatal intracranial haemorrhage during the perinatal period. We report treatment of a 32-year-old primigravida who fell into a deep coma during labour with fetal distress, complicated by a spontaneous acute su...

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Bibliographic Details
Published in:Acta neurochirurgica 2009-12, Vol.151 (12), p.1689-1692
Main Authors: Yokota, H., Miyamoto, K., Yokoyama, K., Noguchi, H., Uyama, K., Oku, M.
Format: Article
Language:English
Subjects:
Adult
Case Report
Cerebral Hemorrhage - diagnosis
Cerebral Hemorrhage - etiology
Cerebral Hemorrhage - surgery
Coma - diagnosis
Coma - etiology
Disseminated Intravascular Coagulation - diagnosis
Disseminated Intravascular Coagulation - etiology
Female
HELLP Syndrome - diagnosis
Hematoma, Subdural, Acute - diagnosis
Hematoma, Subdural, Acute - etiology
Hematoma, Subdural, Acute - surgery
Humans
Interventional Radiology
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Obstetric Labor Complications - diagnosis
Obstetric Labor Complications - etiology
Pregnancy
Pregnancy Complications, Hematologic - diagnosis
Pregnancy Complications, Hematologic - etiology
Surgical Orthopedics
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Summary:HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome can result in a fatal intracranial haemorrhage during the perinatal period. We report treatment of a 32-year-old primigravida who fell into a deep coma during labour with fetal distress, complicated by a spontaneous acute subdural haematoma and intracerebral haemorrhage. Simultaneous emergency operations, evacuation of the acute subdural haematoma and a caesarean section, were performed, during which a diagnosis of HELLP syndrome with disseminated intravascular coagulation was made. Both mother and infant recovered, though hemiparesis persisted in the mother. Patients with HELLP syndrome should be managed as high-risk, which requires an excellent working relationship of the physicians involved. Prompt recognition of intracranial haemorrhagic complications and neurosurgical intervention are particularly important.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-009-0300-y