Disociación clinicorradiológica en la hemorragia cerebral por afibrinogenemia
Introduction. Congenital afibrinogenemia is a very rare hereditary anomaly of coagulation. Only 150 cases have been published. Clinical manifestation in the form of some type of bleeding is similar to that of other congenital coagulopathies,although the pattern of presentation is different. Spontaneous bleeding is rare, but slight injury, which may be unnoticed, may trigger it off. In spite of being a congenital condition, it may be of late onset, as in our patient, with bleeding episodes occurring in the second decade of life. Clinical case. We describe a woman who had several episodes of bleeding, two of which were intra-cerebral. The principal feature of this was dissociation between the clinical findings and their detection by neuro-imaging.Substitutive therapy led to the disappearance of symptoms. Conclusion. Cerebral haemorrhage in the presence of afibrinoge-nemia may fail to be detected early on CT. On clinical suspicion of bleeding, early substitutive treatment should be started
Caso clínico Se describe a una paciente que padeció diferentes hemorragias, entre ellas dos intracerebrales, cuyo rasgo principal fue la existencia de una disociación entre las manifestaciones clínicas y su detección por neuroimagen. El tratamiento sustitutivo consiguió la desaparición de los síntomas.
Conclusiones La presentación de una hemorragia cerebral en el marco de una afibrinogenemia puede no ser detectada precozmente por TAC. Tras la sospecha clínica de sangrado debe instaurarse precozmente el tratamiento sustitutivo
