Challenges in Perioperative management of spontaneous acute subdural hematoma in haemophilia patients

Intracranial hemorrhage in patients with hemophilia is associated high mortality and morbidity. We report a case of 15 years old boy haemophilia A, who presented spontaneous acute subdural hematoma underwent craniotomy for clot evacuation. The patient also received Factor VIII infusions peri-operatively along other measures, to decrease blood loss. signs raised intracranial pressure mannitol intra-operatively postoperatively prevent brain edema. Hypertonic saline (3 ml/kg 3% solution) was given over 30 minutes relaxation. Recommendations peri-operative preparation management haemophilia, especially the setting emergency major surgery were reviewed.