Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage

Background: Intracranial hemorrhage (ICH) is reportedly rare but has high morbidity and mortality risk in persons with hemophilia. Although the risk factors that facilitate bleeding are known, the factors affecting the sequelae are not well known. Objectives: We planned to investigate the risk facto...

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Main Authors: Melike Sezgin Evim, Ayşegül Ünüvar, Canan Albayrak, Emine Zengin, Ebru Yılmaz, Zühre Kaya, Nihal Karadaş, Mehtap Ertekin, Hülya Üzel, Gül Nihal Özdemir, Davut Albayrak, Funda Tayfun Küpesiz, Ayşenur Bahadır, Hüseyin Tokgöz, Kamuran Karaman, Barış Yılmaz, Sinan Akbayram, Burçak Tatlı Güneş, Burcu Belen Apak, Can Acıpayam, Yusuf Ziya Aral, Serap Karaman, Hale Ören
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Research and Practice in Thrombosis and Haemostasis
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475037924003029
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author Melike Sezgin Evim
Ayşegül Ünüvar
Canan Albayrak
Emine Zengin
Ebru Yılmaz
Zühre Kaya
Nihal Karadaş
Mehtap Ertekin
Hülya Üzel
Gül Nihal Özdemir
Davut Albayrak
Funda Tayfun Küpesiz
Ayşenur Bahadır
Hüseyin Tokgöz
Kamuran Karaman
Barış Yılmaz
Sinan Akbayram
Burçak Tatlı Güneş
Burcu Belen Apak
Can Acıpayam
Yusuf Ziya Aral
Serap Karaman
Hale Ören
author_facet Melike Sezgin Evim
Ayşegül Ünüvar
Canan Albayrak
Emine Zengin
Ebru Yılmaz
Zühre Kaya
Nihal Karadaş
Mehtap Ertekin
Hülya Üzel
Gül Nihal Özdemir
Davut Albayrak
Funda Tayfun Küpesiz
Ayşenur Bahadır
Hüseyin Tokgöz
Kamuran Karaman
Barış Yılmaz
Sinan Akbayram
Burçak Tatlı Güneş
Burcu Belen Apak
Can Acıpayam
Yusuf Ziya Aral
Serap Karaman
Hale Ören
author_sort Melike Sezgin Evim
collection DOAJ
description Background: Intracranial hemorrhage (ICH) is reportedly rare but has high morbidity and mortality risk in persons with hemophilia. Although the risk factors that facilitate bleeding are known, the factors affecting the sequelae are not well known. Objectives: We planned to investigate the risk factors for neurologic sequelae in children and adolescents with hemophilia suffering from ICH. Methods: An invitation was sent to pediatric hematology centers via email. Clinical and laboratory findings, neurologic sequelae, and recurrence of bleeding in persons with hemophilia who developed ICH were questioned. Results: Eighty-six patients from 21 centers were evaluated. All patients were less than 18 years of age at the time of ICH. Thirteen patients had ICH in the neonatal period, while 40 patients had a known diagnosis of hemophilia before ICH, and 33 patients were undiagnosed before ICH. Five patients died, 2 of whom died in the neonatal period. The rate of neurologic sequelae was 25 of 81 (30%). The most common neurologic sequela was epilepsy (n = 11/25), followed by hemiparesis (n = 5/25). Cerebral shift (odds ratio, 3.48) and development of ICH in the neonatal period (odds ratio, 4.67) were significant for the development of neurologic sequelae in multivariate analysis. On follow-up, recurrence of ICH occurred in 8 of 81 (10%). Conclusion: ICH in the neonatal period and cerebral shift were the two main risk factors for the development of neurologic sequelae. Neonatal departments must be alert to the signs of bleeding. It is important for healthcare professionals to overcome the barriers to primary prophylaxis and to take trauma-related precautions.
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spelling doaj-art-ba8fbd3ea0194cf587a18bc30f6e5f0d2024-12-21T04:29:26ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792024-11-0188102607Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhageMelike Sezgin Evim0Ayşegül Ünüvar1Canan Albayrak2Emine Zengin3Ebru Yılmaz4Zühre Kaya5Nihal Karadaş6Mehtap Ertekin7Hülya Üzel8Gül Nihal Özdemir9Davut Albayrak10Funda Tayfun Küpesiz11Ayşenur Bahadır12Hüseyin Tokgöz13Kamuran Karaman14Barış Yılmaz15Sinan Akbayram16Burçak Tatlı Güneş17Burcu Belen Apak18Can Acıpayam19Yusuf Ziya Aral20Serap Karaman21Hale Ören22Division of Pediatric Hematology, Uludag University Faculty of Medicine, Bursa, Turkey; Correspondence Melike Sezgin Evim, Uludag University, Faculty of Medicine, Sabahattin Gazioglu Pediatric Hematology, Oncology and Stem Cell Transplantation Center, Campus of Gorukle, Nilüfer, Bursa 16059, Turkey.Division of Pediatric Hematology and Oncology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, TurkeyDivision of Pediatric Hematology and Oncology, Ondokuz Mayis University Faculty of Medicine, Samsun, TurkeyDivision of Pediatric Hematology, Kocaeli University Faculty of Medicine, Kocaeli, TurkeyDivision of Pediatric Hematology and Oncology, Erciyes University Faculty of Medicine, Kayseri, TurkeyDivision of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, TurkeyDivision of Pediatric Hematology, Ege University Faculty of Medicine, İzmir, TurkeyDivision of Pediatric Hematology, Bakırçay University, Çiğli Training and Research Hospital, İzmir, TurkeyDivision of Pediatric Hematology and Oncology, Dicle University Faculty of Medicine, Diyarbakır, TurkeyDivision of Pediatric Hematology, İstinye University Faculty of Medicine, İstanbul, TurkeyDivision of Pediatric Hematology and Oncology, Medicalpark Samsun Hospital, Samsun, TurkeyDivision of Pediatric Hematology and Oncology, Akdeniz University Faculty of Medicine, Antalya, TurkeyDivision of Pediatric Hematology and Oncology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDivision of Pediatric Hematology, Necmettin Erbakan University Faculty of Medicine, Konya, TurkeyDivision of Pediatric Hematology, Van 100.yıl University Faculty of Medicine, Van, TurkeyDivision of Pediatric Hematology and Oncology, Marmara University Faculty of Medicine, İstanbul, TurkeyDivision of Pediatric Hematology and Oncology, Gaziantep University Faculty of Medicine, Gaziantep, TurkeyDivision of Pediatric Hematology, İzmir Tepecik Training and Research Hospital, İzmir, TurkeyDivision of Pediatric Hematology and Oncology, Başkent University Faculty of Medicine, Ankara, TurkeyDivision of Pediatric Hematology and Oncology, Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TurkeyDivision of Pediatric Hematology, Adnan Menderes University Faculty of Medicine, Aydın, TurkeyDivision of Pediatric Hematology and Oncology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, TurkeyDivision of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, TurkeyBackground: Intracranial hemorrhage (ICH) is reportedly rare but has high morbidity and mortality risk in persons with hemophilia. Although the risk factors that facilitate bleeding are known, the factors affecting the sequelae are not well known. Objectives: We planned to investigate the risk factors for neurologic sequelae in children and adolescents with hemophilia suffering from ICH. Methods: An invitation was sent to pediatric hematology centers via email. Clinical and laboratory findings, neurologic sequelae, and recurrence of bleeding in persons with hemophilia who developed ICH were questioned. Results: Eighty-six patients from 21 centers were evaluated. All patients were less than 18 years of age at the time of ICH. Thirteen patients had ICH in the neonatal period, while 40 patients had a known diagnosis of hemophilia before ICH, and 33 patients were undiagnosed before ICH. Five patients died, 2 of whom died in the neonatal period. The rate of neurologic sequelae was 25 of 81 (30%). The most common neurologic sequela was epilepsy (n = 11/25), followed by hemiparesis (n = 5/25). Cerebral shift (odds ratio, 3.48) and development of ICH in the neonatal period (odds ratio, 4.67) were significant for the development of neurologic sequelae in multivariate analysis. On follow-up, recurrence of ICH occurred in 8 of 81 (10%). Conclusion: ICH in the neonatal period and cerebral shift were the two main risk factors for the development of neurologic sequelae. Neonatal departments must be alert to the signs of bleeding. It is important for healthcare professionals to overcome the barriers to primary prophylaxis and to take trauma-related precautions.http://www.sciencedirect.com/science/article/pii/S2475037924003029adolescentschildrenhemophiliaintracranial hemorrhageoutcome
spellingShingle Melike Sezgin Evim
Ayşegül Ünüvar
Canan Albayrak
Emine Zengin
Ebru Yılmaz
Zühre Kaya
Nihal Karadaş
Mehtap Ertekin
Hülya Üzel
Gül Nihal Özdemir
Davut Albayrak
Funda Tayfun Küpesiz
Ayşenur Bahadır
Hüseyin Tokgöz
Kamuran Karaman
Barış Yılmaz
Sinan Akbayram
Burçak Tatlı Güneş
Burcu Belen Apak
Can Acıpayam
Yusuf Ziya Aral
Serap Karaman
Hale Ören
Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
Research and Practice in Thrombosis and Haemostasis
adolescents
children
hemophilia
intracranial hemorrhage
outcome
title Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
title_full Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
title_fullStr Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
title_full_unstemmed Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
title_short Risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
title_sort risk factors for neurologic sequelae in children and adolescents with hemophilia after intracranial hemorrhage
topic adolescents
children
hemophilia
intracranial hemorrhage
outcome
url http://www.sciencedirect.com/science/article/pii/S2475037924003029
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