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登革热并发自发性急性硬膜下血肿:病例报告及文献复习

Spontaneous acute subdural hematoma in dengue fever: Case report and review of the literature.

作者信息

Siahaan Andre Marolop Pangihutan, Tandean Steven, Saragih Edwin Batara, Nainggolan Bahagia Willibrordus Maria

机构信息

Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

Int J Surg Case Rep. 2022 Sep;98:107512. doi: 10.1016/j.ijscr.2022.107512. Epub 2022 Aug 13.

Abstract

INTRODUCTION AND IMPORTANCE

A very uncommon dengue fever consequence is subdural hematoma. IgG positivity, increased AST, and ALT levels may all be risk factors for bleeding in dengue fever patients.

CASE PRESENTATION

We report the case of a 65-year-old man who presented with dengue fever symptoms and developed altered consciousness and focal neurological deficits. The findings of the tests showed thrombocytopenia, increased AST and ALT, positive anti-dengue IgG, and subdural hematoma on brain imaging. The urgent operations were completed satisfactorily.

CLINICAL DISCUSSION

Dengue-related intracerebral haemorrhage is still a complicated condition. Thrombocytopenia and leukopenia are the first symptoms that point to dengue. Some risk factors, such as thrombocytopenia and increased AST and ALT, have been identified as bleeding factors in dengue fever. For a possible intracerebral haemorrhage, radiological imaging should be performed. In an emergency neurosurgery setting, thrombocyte administration could be used to monitor thrombocytopenia.

CONCLUSION

Subdural hematoma is a possible dengue fever complication. If the patient's symptoms with thrombocytopenia and elevated liver enzymes indicate the possibility of intracranial haemorrhage, immediate radiological imaging should be performed.

摘要

引言与重要性

硬膜下血肿是登革热一种非常罕见的后果。IgG阳性、AST和ALT水平升高可能都是登革热患者出血的危险因素。

病例介绍

我们报告一例65岁男性病例,该患者出现登革热症状,并出现意识改变和局灶性神经功能缺损。检查结果显示血小板减少、AST和ALT升高、抗登革热IgG阳性,脑部影像学检查发现硬膜下血肿。紧急手术圆满完成。

临床讨论

登革热相关的脑出血仍然是一种复杂的病症。血小板减少和白细胞减少是提示登革热的首要症状。一些危险因素,如血小板减少以及AST和ALT升高,已被确定为登革热的出血因素。对于可能的脑出血,应进行放射影像学检查。在紧急神经外科手术中,可使用血小板输注来监测血小板减少情况。

结论

硬膜下血肿是登革热可能的并发症。如果患者出现血小板减少和肝酶升高的症状提示有颅内出血的可能,应立即进行放射影像学检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/940e/9411658/d355047219de/gr1.jpg

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