Puapong Devin, Terasaki Keith, Lacerna Melinda, Applebaum Harry
Division of Pediatric Surgery and Interventional Radiology, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA.
J Pediatr Surg. 2005 May;40(5):869-71. doi: 10.1016/j.jpedsurg.2005.02.005.
Although relatively rare, intracranial hemorrhage remains the most common cause of immune thrombocytopenic purpura-related mortality [Medeiros D. Current controversies in the management of idiopathic thrombocytopenic purpura during childhood. Pediatr Clin North Am . 1996;43:757-72]. The required decompressive treatment has the potential for substantial blood loss and must often be delayed because of resistant thrombocytopenia responsive only to splenectomy. Splenic embolization is a novel approach to this problem that can expedite definitive neurosurgical care and minimize permanent sequelae. This is the first reported case of splenic embolization in the management of a child with known immune thrombocytopenic purpura presenting with central nervous system bleeding.
