Recombinant Activated Factor VII in the Treatment of Subdural Haematoma of a Neonate with Acquired Factor VII Deficiency

Czech version

Authors: K. Toušovská ¹; Z. Kokštein ¹; P. Bašek ¹; P. Rejtar ²; J. Jakubec ³; V. Pecka ³
Authors‘ workplace: Dětská klinika FN, Hradec Králové, přednostka doc. MUDr. E. Pařízková, CSc. Radiodiagnostická klinika FN, Hradec Králové, 2 přednosta doc. MUDr. P. Eliáš, CSc. Neurochirurgická klinika FN, Hradec Králové, 3 přednosta doc. MUDr. J. Náhlovský, CSc. Oddělení
Published in: Čes-slov Pediat 2002; (9): 519-522.
Category:

Overview

The authors present the tase-record of a normal matur neonate where clinical deterioration occurred 10 hours after delivery. Imaging revealed a massive subdural and subgaleal haematoma on the left with incipient tonus syndrome. Coagulation screening made during the llth hour after delivery revealed a significant isolated prolongation of the thrombin time. Urgent puncture of the haematoma was made and substitution treatment was started. With regard to the working diagnosis of congenital fVII deficiency after the initial administration of antihaemophil plasma and prothrombin complex concentrate the authors proceeded with substitution of recombinant activated fVII (Novo 5even, Novo Nordisk). Coagulation parameters became normal immediately after treatment was started, following its termination after 7 days the prothrombin time remained normal. The patient's clinical condition became gradually stabilized, no relapse of haemorrhage occurred. The condition is most probably a posttraumatic subdural haematoma of a neonate with a secondary coagulopathy affecting selectively the external pathway of haemostasis.

Key words:
neonate, haemorrhage, coagulopathy, factor VII

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