Management of intracranial hemorrhage in a child with a left ventricular assist device

Raqeeb Haque, Teresa Wojtasiewicz, Rabin Gerrah, Lisa Gilmore, Yoshikatsu Saiki, Jonathan M. Chen, Marc Richmond, Neil A. Feldstein, Richard C.E. Anderson

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Pediatric patients bridged to heart transplant with LVADs require chronic anticoagulation and are at increased risk of hemorrhagic complications, including intracranial hemorrhage. In this population, intracranial hemorrhage is often fatal. We report a case of successful management of a five-yr-old-boy with DCM on an LVAD who developed a subdural hematoma. We initially chose medical management, weighing the patient's high risk of thromboembolism from anticoagulation reversal against the risk of his chronic subdural hematoma. When head CT showed expansion of the hemorrhage with increasing midline shift, we chose prompt surgical evacuation of the hematoma with partial reversal of anticoagulation, given the increased risk of acute deterioration. The patient ultimately received an orthotopic heart transplant and was discharged with no permanent neurological complications. This represents a case of a pediatric patient on an LVAD who survived a potentially fatal subdural hematoma and was successfully bridged to cardiac transplantation.

Original languageEnglish
Pages (from-to)E135-E139
JournalPediatric Transplantation
Volume16
Issue number5
DOIs
Publication statusPublished - 2012 Aug

Keywords

  • neurological complications
  • pediatric heart transplant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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