Hemophilia B With Intracranial Hemorrhage Rehabilitation in High-Dependency Unit: A Case Report

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL

Clinical Case Reports Pub Date : 2025-04-21 DOI:10.1002/ccr3.70470

Xiaoyan Feng, Hongjun Zhu, Liying Han, Hongxing Xu, Lei He

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Abstract

Hemophilia B, an X-linked recessive coagulation disorder, poses significant risks of life-threatening intracranial hemorrhage (ICH). This case report details the multidisciplinary rehabilitation of a 41-year-old male with moderate hemophilia B (FIX activity: 3.9%) and ICH in a resource-limited setting. Admitted to a high-dependency unit postneurosurgical intervention, the patient received low-dose prophylactic coagulation factor IX (maintained at 34.6%–66.2%) alongside real-time coagulation monitoring. A stepwise rehabilitation protocol was implemented, including early passive joint mobilization, neuromuscular electrical stimulation, and progressive task-oriented training, tailored to minimize bleeding risk. Over 7 weeks, the patient achieved marked functional improvement: Activity of Daily Living score increased from 0 to 80, modified Rankin Scale improved from 5 to 3, and Fugl-Meyer Assessment (FMA) rose from 0 to 60, with no secondary bleeding. This case highlights the feasibility of integrating low-dose prophylaxis with early rehabilitation in developing countries, offering a cost-effective model to enhance functional recovery and reduce disability in hemophilia-related ICH.

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B 型血友病伴颅内出血患者在重症监护病房的康复治疗：病例报告

血友病B是一种x连锁的隐性凝血障碍，具有危及生命的颅内出血（ICH）的重大风险。本病例报告详细介绍了在资源有限的情况下，41岁男性中度血友病B （FIX活性：3.9%）和脑出血的多学科康复。患者在神经外科干预后入住高依赖病房，接受低剂量预防性凝血因子IX（维持在34.6%-66.2%）并进行实时凝血监测。实施逐步康复方案，包括早期被动关节活动，神经肌肉电刺激和渐进式任务导向训练，以尽量减少出血风险。7周后，患者的功能得到明显改善：日常生活活动评分从0分提高到80分，改良Rankin量表从5分提高到3分，Fugl-Meyer评估（FMA）从0分提高到60分，无继发出血。该病例强调了在发展中国家将低剂量预防与早期康复相结合的可行性，为加强血友病相关脑出血的功能恢复和减少残疾提供了一种具有成本效益的模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Case Reports MEDICINE, GENERAL & INTERNAL-

自引率

14.30%

发文量

1268

审稿时长

13 weeks

期刊介绍： Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).