[Perioperative management of intracranial hemorrhage related to hematological disease].

Six patients with hematological disease complicated by intracranial hemorrhage were surgically treated in the last 2 years. In this study, in order to clarify indication for operation and perioperative management, 6 cases were classified into 2 groups. The details of each group were as follows: Group 1 was defined by the fact that the underlying hematological disease had not yet been controlled. (One case was ITP and the others were 2 AML cases). Group 2 was defined by the fact that the underlying hematological disease was well controlled. (One case was CML, one case was ATL and one case was ITP). A tendency to bleed was corrected in all patients of group 1 in the perioperative period. In the AML cases, prevention of infection was mandatory because both AML cases had been in remission, and no serious postoperative complication had occurred. The outcome of short term treatment was excellent in all but one case, in whom the recurrence of subdural hematoma caused death during the period 1 month after operation. On the other hand, no cases classified in group 2 needed specific hematological perioperative management and the short term treatment outcome was excellent. Since intracranial hemorrhage related to hematological disease has often been fatal, those patients were treated conservatively in most cases. However, from our analyses, we were able to emphasize that most intracranial hemorrhage related to hematological disease might be treated surgically and with good result, if the underlying hematological disease has entered the remission period.