Cerebral Hemorrhage in Hemophilia

Intracranial hemorrhage in hemophilia is an unusual manifestation of the disease. The cases hitherto reported have been those of subarachnoid rather than of intracerebral hemorrhage. Indeed, Gunther,2 writing in 1935, stated that no substantiated instance of cerebral hemorrhage in a hemophiliac had been detailed up to that date. Von Limbeck,5 however, is credited with the description of such a case. Hemophilia in a child, with effusion of blood into the ventricles, was reported by Traneus,4 but a negative family history and absence of previous hemorrhagic episodes were specifically mentioned. This patient was cited in the comprehensive review of Bulloch and Fildes' but no other instance of cerebral hemorrhage substantiated by necropsy was included. Rosenthal3 stated that he observed one case of fatal cerebral hemorrhage, but gave no details. The present communication is made because of the unequivocal evidence of hemophilia in a patient who died as the result of a massive cerebral hemorrhage.