Abstract:

Objective      Three cases of brain hernia caused by craniocerebral trauma combined with hemostatic abnormalities were presented to improve diagnosis and surgical treatment for such a special disease. Method      Two hemophilia A and one idiopathic thrombocytopenia purpura (ITP) patients presented with brain hernia due to  craniocerebral trauma with intracranial hemorrhage (ICH) which was confirmed by CT scanning. After timely dehydration and platelet/cryoprecipitate transfusion within 3 hours to correct the blood coagulation functioning, an emergency craniotomy was performed to remove the intracranial haematoma. Results       The intracranial haematoma of all three patients was cleared without secondary hemorrhage. Two hemophilia A patients recovered well and were discharged later. The ITP patient improved and was transferred to the department of hematology for further therapy. Conclusions        With temporarily normal hemostatic functioning, dedicated and standard perioperative management is the key to ensure the effectiveness of  surgical treatment and ideal prognosis.

Key words: Hemostatic abnormality;  Trauma;  Brain hernia;  Surgery