Extra-Axial Hematoma and Trimethoprim-Sulfamethoxazole Induced Aplastic Anemia: The Role of Hematological Diseases in Subdural and Epidural Hemorrhage. (23rd June 2015)

• Record Type: Journal Article
• Authors: Menger, Richard P.; Dossani, Rimal H.; Thakur, Jai Deep; Farokhi, Frank; Morrow, Kevin; Guthikonda, Bharat
• Other Names: Nakase Kazunori Academic Editor.
• Is Part Of: Case reports in hematology. Volume 2015(2015)
• Publication Date: 2015-06-23
• Subjects: Hematology -- Periodicals; Hematology -- Case studies -- Periodicals; Blood -- Diseases -- Periodicals; Hematology; Hematologic Diseases; Blood -- Diseases; Hematology; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.15
• DOI: 10.1155/2015/374951
• Languages: English
• ISSNs: 2090-6560

Abstract

Abstract : Objective and Importance . To illustrate the development of spontaneous subdural hematoma secondary to aplastic anemia resulting from the administration of trimethoprim-sulfamethoxazole. This is the first report of trimethoprim-sulfamethoxazole potentiating coagulopathy leading to any form of intracranial hematoma. Clinical Presentation . A 62-year-old female developed a bone marrow biopsy confirmed diagnosis of aplastic anemia secondary to administration of trimethoprim-sulfamethoxazole following a canine bite. She then developed a course of waxing and waning mental status combined with headache and balance related falls. CT imaging of the head illustrated a 3.7 cm× 6.6 mm left frontal subdural hematoma combined with a 7.0 mm× 1.7 cm left temporal epidural hematoma. Conclusion . Aplastic anemia is a rare complication of the administration of trimethoprim-sulfamethoxazole. Thrombocytopenia, regardless of cause, is a risk factor for the development of spontaneous subdural hematoma. Given the lack of a significant traumatic mechanism, this subset of subdural hematoma is more suitable to conservative management.