• Arq Neuropsiquiatr · Jun 2007

    Central nervous system hemorrhage in thrombocytopenic patients: computed tomographic findings in 21 cases.

    • Emerson L Gasparetto, Paulo R Benites Filho, Taísa Davaus, and Arnolfo de Carvalho Neto.
    • Department of Internal Medicine, University of Paraná School of Medicine, and Hospitalde Clínicas, Curitiba, Brazil. egasparetto@gmail.com
    • Arq Neuropsiquiatr. 2007 Jun 1;65(2A):268-72.

    ObjectiveTo describe the CT scan findings of 21 thrombocytopenic patients with central nervous system (CNS) hemorrhage.MethodRetrospective study of the computed tomography (CT) of 21 platelet-depleted patients with CNS hemorrhage. One patient presented two episodes of hemorrhagic episode with different intervals. The clinical data were obtained by the review of the medical records. Two radiologists analyzed the films and reached the decisions by consensus. The following findings were studied: type of bleeding, number of lesions, topography, laterality, size and associated findings.ResultsIntraparenchymal hemorrhage (IPH) was the most common findings, found in 20 cases, being six of them associated with subarachnoid and intraventricular hemorrhages. The size of the lesions varied between 1.8 and 10.5 cm. The parietal lobes were more commonly affected (n=11, 50%), followed by the temporal (n=7, 31.8%), frontal (n=7, 31.8%) and occipital (n=2, 9.09%) lobes. In 15 cases (68.2%) there was a single area of hemorrhage and in the remaining cases there were multiple hemorrhages. Associated findings were found in 20 cases. The most prevalent were edema (n=17, 77.3%), hydrocephalus (10, 45.4%) and midline shift (n=9, 41%).ConclusionThe most frequent CT scan findings in thrombocytopenic patients with CNS hemorrhage are single IPH, located mostly in the parietal, temporal and frontal lobes, with varied sizes and associated with edema, hydrocephalus and midline shift.

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