Bilateral subthalmic nucleus deep brain stimulation with microelectrode recordings in the setting of mild inherited hemophilia B: a case report

The International Journal of Neuroscience
Abdulraheem YacoubJules M Nazzaro

Abstract

Hemophilia B is an X linked recessive deficiency of factor IX that presents with a range of clinical severity that co-relates with factor levels. Although guidelines exist to guide perioperative hemostasis in such patients, there is scarce data on elective high-risk neurosurgeries, resulting in a reluctance to offer these patients elective neurosurgeries. These patients thus rarely if ever undergo such procedures. We report a unique case of undiagnosed mild hemophilia B in a gentleman that was found incidentally at age 64 during pre-operative workup. This gentleman had intractable Parkinson's disease for which subthalmic deep brain stimulation was indicated. He was found to have a prolonged APTT on initial lab testing. After subsequent workup, and having excluded the presence of inhibitors, he was diagnosed with Hemophilia B. With the use of Factor IX concentrates (AlphaNine®) and close clinical, laboratory, and radiological monitoring a plan was made for this patient to undergo this procedure. Our patient successfully underwent subthalmic deep brain stimulation with microelectrode recordings and intraoperative test stimulation in a two-step procedure, followed by single channel implantable neurostimulator and extension wire im...Continue Reading

References

Sep 27, 2003·Haemophilia : the Official Journal of the World Federation of Hemophilia·J HanrahanP Mathew
May 4, 2012·BMJ : British Medical Journal·Karin FijnvandraatMarjolein Peters
Jul 11, 2012·Haemophilia : the Official Journal of the World Federation of Hemophilia·A SrivastavaUNKNOWN Treatment Guidelines Working Group on Behalf of The World Federation Of Hemophilia
Mar 16, 2013·Journal of Anaesthesiology, Clinical Pharmacology·Prakhar Gyanesh, Sanjay Dhiraaj
Oct 15, 2013·American Journal of Clinical Pathology·Nahla M HeikalKristi J Smock

❮ Previous
Next ❯

Citations

Apr 14, 2020·World Neurosurgery·Ryan PalsmaWillard S Kasoff

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.