Thrombocytopenia induces multiple intracranial hemorrhages in patients with severe burns: A review of 16 cases

Zhou,Jianda; Liu,Jinyan; Luo,Chengqun; Hu,Feng; Liu,Rui; Chen,Zizi; Chen,Yao; Xiong,Wu; Xie,Jianfei; He,Quanyong; Yin,Chaoqi; Wang,Shaohua; Zhang,Yanwen; Zeng,Sainan

doi:10.3892/etm.2013.1081

Thrombocytopenia induces multiple intracranial hemorrhages in patients with severe burns: A review of 16 cases

Authors:
- Jianda Zhou
- Jinyan Liu
- Chengqun Luo
- Feng Hu
- Rui Liu
- Zizi Chen
- Yao Chen
- Wu Xiong
- Jianfei Xie
- Quanyong He
- Chaoqi Yin
- Shaohua Wang
- Yanwen Zhang
- Sainan Zeng
View Affiliations

Affiliations: The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
Published online on: April 29, 2013 https://doi.org/10.3892/etm.2013.1081
Pages: 223-227

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of this study was to explore the etiology and diagnosis of multiple intracranial hemorrhages (ICHs) following severe burns, with a retrospective review of 16 cases of severe burns further complicated by multiple ICHs. Using cranial CT scans of the brains, we identified that all patients presented with low platelet counts and coagulation abnormalities prior to intracranial hemorrhaging. Following conventional treatment and various supporting treatments, five cases succumbed following a progressive reduction in blood platelet levels and the ICHs were cured in 11 cases following the restoration of normal platelet levels. We conclude that low platelet counts and coagulation abnormalities may cause multiple ICHs following severe burns and early diagnosis and treatment is the key to successful treatment.

View Figures

View References

1.	Fu Y, Xie B, Ben D, et al: Pathogenic alteration in severe burn wounds. Burns. 38:90–94. 2012. View Article : Google Scholar : PubMed/NCBI
2.	Kushner D: Mild traumatic brain injury: toward understanding manifestations and treatment. Arch Intern Med. 158:1617–1624. 1998. View Article : Google Scholar : PubMed/NCBI
3.	Zhu H, Li F, Zou M, et al: Experimental high-altitude intracerebral hemorrhage in minipigs: histology, behavior and itracranial pressure in a double-injection model. Acta Neurochir (Wien). 155:655–661. 2013. View Article : Google Scholar
4.	Lee J, Evans CS, Singh N, et al: Head computed tomography utilization and intracranial hemorrhage rates. Emerg Radiol. Dec 19–2012.(Epub ahead of print).
5.	Hart DW, Wolf SE, Mlcak R, et al: Persistence of muscle catabolism after severe burn. Surgery. 128:312–319. 2000. View Article : Google Scholar : PubMed/NCBI
6.	Gauglitz GG, Herndon DN, Kulp GA, Meyer WJ III and Jeschke MG: Abnormal insulin sensitivity persists up to three years in pediatric patients post-burn. J Clin Endocrinol Metab. 94:1656–1664. 2009.PubMed/NCBI
7.	Jeschke MG, Chinkes DL, Finnerty CC, et al: Pathophysiologic response to severe burn injury. Ann Surg. 248:387–401. 2008.PubMed/NCBI
8.	Cho SJ, Minn YK and Kwon KH: Stroke after burn. Cerebrovasc Dis. 24:261–263. 2007. View Article : Google Scholar : PubMed/NCBI
9.	Winkelman MD and Galloway PG: Central nervous system complications of thermal burns. A postmortem study of 139 patients. Medicine (Baltimore). 71:271–283. 1992. View Article : Google Scholar : PubMed/NCBI
10.	Huisse MG, Pease S, Hurtado-Nedelec M, et al: Leukocyte activation: The link between inflammation and coagulation during heatstroke. A study of patients during the 2003 heat wave in Paris. Crit Care Med. 36:2288–2295. 2008. View Article : Google Scholar : PubMed/NCBI
11.	Marshall JC: Inflammation, coagulopathy, and the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med. 29:S99–S106. 2001. View Article : Google Scholar : PubMed/NCBI
12.	Schouten M, Wiersinga WJ, Levi M and van der Poll T: Inflammation, endothelium, and coagulation in sepsis. J Leukoc Biol. 83:536–545. 2008. View Article : Google Scholar : PubMed/NCBI
13.	Pawlinski R, Pedersen B, Erlich J and Mackman N: Role of tissue factor in haemostasis, thrombosis, angiogenesis and inflammation: Lessons from low tissue factor mice. Thromb Haemost. 92:444–450. 2004.PubMed/NCBI
14.	Cho SJ, Minn YK and Kwon KH: Stroke after burn. Cerebrovasc Dis. 24:261–263. 2007. View Article : Google Scholar : PubMed/NCBI
15.	Xie HQ, Zhou JD, Nie XM, et al: HSP70 inhibits burn serum-induced apoptosis of cardiomyocytes via mitochondrial and membrane death receptor pathways. J Burn Care Res. 29:512–518. 2008. View Article : Google Scholar : PubMed/NCBI
16.	Murray CK, Loo FL, Hospenthal DR, et al: Incidence of systemic fungal infection and related mortality following severe burns. Burns. 34:1108–1112. 2008. View Article : Google Scholar : PubMed/NCBI
17.	Cox RA, Mlcak RP, Chinkes DL, et al: Upper airway mucus deposition in lung tissue of burn trauma victims. Shock. 29:356–361. 2008.PubMed/NCBI
18.	Rosanova M, Epelbaum C, Noman A, et al: Use of colistin in a pediatric burn unit in Argentina. J Burn Care Res. 30:612–615. 2009. View Article : Google Scholar : PubMed/NCBI