Authors: Shahlaie, Kiarash¹; Fox, Andrew¹; Butani, Lavjay²; Boggan, James³

Source: Pediatric Nephrology, Volume 19, Number 10, October 2004 , pp. 1168-1172(5)

Publisher: Springer

Abstract:

Spontaneous epidural hemorrhage has been described in a variety of clinical scenarios, including chronic renal failure (CRF). During hemodialysis, patients with CRF rarely develop spinal or cranial epidural hematomas. Such hemorrhages have been attributed to intracranial pressure fluctuations during hemodialysis, heparin administration, uremic-platelet syndrome, or hypertension. Although the exact pathophysiology is not understood, this rare consequence of hemodialysis has been well documented in the literature. Hemorrhage in the absence of hemodialysis therapy in a CRF patient, however, has not been previously reported. We report a 16-year-old boy with no history of trauma who woke in the morning with severe headache and resultant neurological deterioration. He was found to have a large left tempero-parietal epidural hematoma and underwent urgent surgical evacuation. Postoperatively he developed a contralateral extra-axial hematoma that did not require surgical intervention. He recovered completely, with no significant neurological deficit. This unique presentation of spontaneous intracranial epidural hemorrhage in an adolescent not receiving hemodialysis highlights a rare, but serious, complication of CRF.

Keywords: Epidural hematoma; Chronic renal failure; Spontaneous; Intracranial

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00467-004-1551-8

Affiliations: 1: Department of Neurological Surgery, Davis Medical Center, University of California, Sacramento, California, USA, 2: Department of Pediatrics, Davis Medical Center, University of California, Sacramento, California, USA, 3: Department of Neurological Surgery, Davis Medical Center, University of California, Sacramento, California, USA, Email: jeboggan@ucdavis.edu

Publication date: 2004-10-01

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