Bilateral frontotemporal subdural hematomain ITP: case report.

Abstract

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease related to low platelet levels, relatively frequent, whose main clinical finding is spontaneous bleeding. Petechiae, gingival bleeding, epistaxes, melena and genitourinary bleeding are common manifestations, and although rare, intracranial bleeding is a severe complication of the disease. Exclusion differential diagnosis is necessary and the treatment is mainly based in corticosteroids, immunoglobulin and splenectomy, according to the clinical picture. In the case report, a complicated ITP with intracranial hemorrhage is presented, determined only after brain MRI, an imaging test that is more sensitive to infiltrative processes when compared to CT. The patient was transferred to hematology to evaluate other treatment options due to the persistence of low platelet counts. Faced with this situation, splenectomy was performed with increased platelet levels and suspension of corticosteroids.