Open Access
CC BY 4.0 · J Neuroanaesth Crit Care 2025; 12(02): 130-132
DOI: 10.1055/s-0045-1809707
Case Report

Intracranial Hemorrhage in a Patient of Hemophilia A with Factor VIII Inhibitors Positive: A Case Report

Autor*innen

  • Melvin K. Ninan

    1   Department of Neuroanaesthesia, Apollo Hospitals, Hyderābād, Telangāna, India
  • Prabhu K. Chennupati

    1   Department of Neuroanaesthesia, Apollo Hospitals, Hyderābād, Telangāna, India
  • Shekhar R. Gurrala

    2   Department of Neuroanaesthesia and Critical Care, Apollo Hospitals, Hyderābād, Telangāna, India

Abstract

Management of intracranial hemorrhage in a patient with hemophilia A and high-titer inhibitors presents a significant challenge to the neurointensivist. The decision between conservative and surgical approaches involves a delicate risk–benefit balance. While conservative management is costly and carries the risk of sudden deterioration, surgical intervention is often complicated by the high likelihood of rebleeding. We report the successful critical care management of a 50-year-old male with hemophilia A and high-titer factor VIII inhibitors who presented with an acute-on-chronic subdural hematoma. His factor VIII levels were markedly low, and conventional factor VIII replacement therapy was ineffective. The bleeding manifestations and laboratory parameters did not improve with standard treatment. The patient was successfully managed using sequential or combined bypassing agent therapy.



Publikationsverlauf

Artikel online veröffentlicht:
16. Juli 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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