Life-Threatening Intracerebral Hemorrhage in Previously Undiagnosed Acute T-Cell Lymphoblastic Leukemia with Blast Crisis: A Nightmare in Neurosurgeon's Life?

Pediatr Neurosurg. 2017;52(4):271-274. doi: 10.1159/000475819. Epub 2017 Jun 1.

Abstract

Spontaneous, nontraumatic intracerebral hemorrhage is a significant cause of morbidity and mortality throughout the world. Acute lymphoblastic leukemia is the most common cancer diagnosed in children. According to the literature, only 6 cases of acute lymphoblastic leukemia presenting as intracerebral hemorrhage have been reported. Five out of the 6 patients were managed conservatively; 3 out of these 6 patients survived with correction of coagulopathy. Surgical intervention was performed in only 1 of the previously reported cases in which the patient could not be salvaged. We report a case of life-threatening intracerebral hemorrhage in previously undiagnosed acute T-cell lymphoblastic leukemia with blast crisis, in which the patient was salvaged from the catastrophic complication after surgical intervention.

Keywords: Acute lymphoblastic leukemia; Children; Intracerebral hemorrhage.

MeSH terms

  • Blast Crisis
  • Cerebral Hemorrhage / complications*
  • Child
  • Diagnosis, Differential
  • Headache / etiology
  • Humans
  • Male
  • Neurosurgeons*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / etiology
  • Treatment Outcome
  • Vomiting / etiology