Dorina AGACHI, Vladimir IACOMI, Galina ESANU, Valentin TUREA
Background: Intracranial hemorrhage represents one of the most severe and potentially fatal complications in children with Hemophilia A, particularly in the presence of inhibitors. Even minor head trauma may trigger life-threatening bleeding requiring urgent multidisciplinary management.
Case: We report the case of a pediatric patient with severe Hemophilia A complicated by inhibitors who developed a large subdural hematoma following minor cranial trauma caused by a football impact. Neurological symptoms appeared within 24 hours and included persistent headache, repeated vomiting, somnolence and progressive neurological impairment. Cranial computed tomography revealed a left fronto-temporo-parietal subdural hemorrhage with midline shift. The child required intensive care admission due to severe clinical deterioration, anemia and convulsive episodes. Multidisciplinary management included aggressive coagulation factor replacement therapy, transfusion support, anticonvulsant treatment and continuous neurological monitoring. Neurosurgical intervention was not indicated, and conservative management was pursued.
Outcome: Gradual clinical stabilization was achieved with regression of neurological symptoms and hemorrhagic manifestations. The patient was discharged in satisfactory condition with recommendations for continued hematologic follow-up.
Conclusion: This case highlights the high risk of severe intracranial bleeding after seemingly minor head trauma in children with Hemophilia A and inhibitors. Early recognition, rapid transfer to specialized centers and coordinated multidisciplinary conservative management may lead to favorable outcomes even in life-threatening situations.
Keywords: Hemophilia A, Subdural hematoma, Intracranial hemorrhage, Minor head trauma, Inhibitors, Pediatric intensive care
https://doi.org/10.59854/dhrrh.2026.4.1.37
