Ann Hematol DOI 10.1007/s00277-012-1448-8
ORIGINAL ARTICLE
Asymptomatic cerebral bleeds in patients with aplastic anemia Sudhir Sharma & Pankaj Malhotra & Vivek Lal & Paramjeet Singh & Neelam Varma & Subhash Varma
Received: 19 May 2011 / Accepted: 11 March 2012 # Springer-Verlag 2012
Abstract Several studies suggest that cerebral microbleeds (CMB) seen on gradient echo magnetic resonance imaging (GE-MRI) of brain increase the future risk of intracranial hemorrhage (ICH). We investigated 26 newly diagnosed patients of aplastic anemia (AA) with GE-MRI of brain who were otherwise neurologically asymptomatic. These patients were then further followed up for a period of 6 months for development of overt ICH. The median age of patients was 20.5 years (range 12–40 years). The median values of complete blood counts at the time of diagnosis were hemoglobin 5.7 gm/dl (range 2.5–9.2 gm/dl), white cell count 2,320/μl (800–7,000/μl), and platelet count 11,500/μl (7000–45,000/μl). Three patients were detected to have CMB while two patients had asymptomatic cerebral macrobleeds (>1 cm). During the follow-up period of 6 months, two patients developed spontaneous ICH. None of the two patients had CMB at diagnosis. In conclusion, S. Sharma : P. Malhotra (*) : S. Varma Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India e-mail:
[email protected] V. Lal Department of Neurology, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India P. Singh Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India N. Varma Department of Hematology, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, India
asymptomatic CMB were found in 11.5 % of patients with AA. The overall prevalence of asymptomatic ICH (CMB & macrobleeds) was 19.2 %. Further studies with larger number of patients are required to clearly delineate the association. Keywords Cerebral microbleeds (CMB) . Aplastic Anemia (AA) . Intracranial hemorrhage
Introduction Intracranial hemorrhage (ICH) is one of the life threatening complications in patients with aplastic anemia (AA) [1]. The risk factors for development of ICH are severe thrombocytopenia (platelet count
