A Case of Spontaneous Intracranial Hematoma with Critically Low Platelet Count: A Neurointensivist's Nightmare

Abstract

Complications of immune thrombocytopenia (ITP) are more frequent at a platelet count lower than 10,000/μL of blood. Intracranial hematoma (ICH) is one of the most severe complications of ITP. Subdural hematoma (SDH) and subarachnoid hemorrhage (SAH) usually occur as extensions of ICH and is generally spontaneous in nature. We report a case of ICH along with SDH and SAH who presented with critically low platelet count managed using apheresis platelet transfusion, desmopressin, intravenous immunoglobulin, and methylprednisolone. The patient was discharged successfully from hospital without any neurological deficit. The importance of early referral and immediate aggressive management and monitoring at an advanced center is suggested.