Published Paper Details:

Neurological involvement is frequent in leukemia but is rarely the inaugural event. We report the case of a 15-year-old boy whose acute lymphoblastic leukemia was revealed by fatal cerebral hemorrhage associated with sepsis secondary to lung infection. Intracerebral hemorrhage remains a cause of death in hematologic malignancies. The patient presented with thrombocytopenia (24,000/mm3), leucostasis and hypofibrinogemia (1.10 g/L). Despite maximal medical and surgical treatment (platelets and fresh-frozen plasma transfusions, red blood cells transfusion, and craniotomy discharge), the patient died. The risk of death is high, and surgical treatment has not proven superior to medical therapy in terms of mortality rates and 6-month survival. Further studies are needed to define consensus guidelines for coagulation disorders induced by ALL and also to define the specific management in cases of ICH in childhood hematological malignancies.