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Review
. 2018;82(3):56-65.
doi: 10.17116/neiro201882356.

[Severe postoperative intracranial hemorrhagic complications in a neurosurgical patient with von Willebrand disease not diagnosed before surgery (a case report and literature review)]

[Article in Russian]
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Free article
Review

[Severe postoperative intracranial hemorrhagic complications in a neurosurgical patient with von Willebrand disease not diagnosed before surgery (a case report and literature review)]

[Article in Russian]
A Yu Lubnin et al. Zh Vopr Neirokhir Im N N Burdenko. 2018.
Free article

Abstract

The article describes a rare clinical case of a patient with previously undiagnosed von Willebrand disease and basal meningioma; an intracranial neurosurgical intervention was complicated by delayed intracranial hematomas, both at the resected tumor site and distantly. The diagnosis of von Willebrand disease was established only after special hematology tests and only after surgery. Despite the use of specific therapy, the patient died due to intracranial hemorrhagic complications in the postoperative period. The paper discusses the problem of preoperative diagnosis of asymptomatic hemostasis disorders in neurosurgical patients and potential ways of its solution.

Дано описание редкого клинического наблюдения: у пациента с ранее не диагностированной болезнью Виллебранда и базальной менингеомой проведенное интракраниальное нейрохирургическое вмешательство осложнилось формированием отсроченных интракраниальных гематом как на месте удаленной опухоли, так и дистантно. Диагноз болезни Виллебранда был установлен только в результате специального исследования в гематологической лаборатории и только после операции. Несмотря на применение специфической терапии, пациент погиб от интракраниальных геморрагических осложнений в послеоперационном периоде. В работе обсуждаются проблема предоперационной диагностики скрытых нарушений гемостаза у нейрохирургических больных и возможные пути ее решения.

Keywords: hemostasis disorders; neurosurgery; postoperative hematomas; von Willebrand disease.

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