Siahaan AMP, Tandean S, Saragih EB, Nainggolan BWM. Spontaneous acute subdural hematoma in dengue fever: Case report and review of the literature.
Int J Surg Case Rep 2022;
98:107512. [PMID:
35985111 PMCID:
PMC9411658 DOI:
10.1016/j.ijscr.2022.107512]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance
A very uncommon dengue fever consequence is subdural hematoma. IgG positivity, increased AST, and ALT levels may all be risk factors for bleeding in dengue fever patients.
Case presentation
We report the case of a 65-year-old man who presented with dengue fever symptoms and developed altered consciousness and focal neurological deficits. The findings of the tests showed thrombocytopenia, increased AST and ALT, positive anti-dengue IgG, and subdural hematoma on brain imaging. The urgent operations were completed satisfactorily.
Clinical discussion
Dengue-related intracerebral haemorrhage is still a complicated condition. Thrombocytopenia and leukopenia are the first symptoms that point to dengue. Some risk factors, such as thrombocytopenia and increased AST and ALT, have been identified as bleeding factors in dengue fever. For a possible intracerebral haemorrhage, radiological imaging should be performed. In an emergency neurosurgery setting, thrombocyte administration could be used to monitor thrombocytopenia.
Conclusion
Subdural hematoma is a possible dengue fever complication. If the patient's symptoms with thrombocytopenia and elevated liver enzymes indicate the possibility of intracranial haemorrhage, immediate radiological imaging should be performed.
Elevated AST and ALT as a risk factor of intracranial bleeding in dengue fever
Immediate radiological imaging to the patients with positive IgG and intracranial haemorrhage symptoms.
Emergency surgical intervention should be conducted depending on patient's status with thorough care in hematologic profile.
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