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Indian Journal of Communicable Diseases 9(1):p 23-27, January-June 2023. | DOI: https://doi.org/10.21088/ijcd.2395.6631.9123.3
Review Article
Dengue Hemorrhagic Fever Presenting with Intracranial Extra-axial Hemorrhage
Krishnendu Choudhury, Chirantan Banerjee, Atithi Biswas
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Communicable Diseases 9(1):p 23-27, January-June 2023. | DOI: https://doi.org/10.21088/ijcd.2395.6631.9123.3
How Cite This Article:
Choudhury K, Banerjee C, Biswas A. Dengue hemorrhagic fever presenting with intracranial extra-axial hemorrhage. Indian J Comm Dis. 2023;9(1):23-27.Timeline
Received : December 09, 2022
Accepted : January 05, 2023
Published : February 28, 2023
Abstract
A 50 yr old male presented with decreased consciousness following fever for consecutive 5
days. Blood pressure was 120/70, pulse rate 100/min. Respiratory and cardiovascular system
examination was normal. There was no abdominal distention or vomiting. Skin rash was absent.
Jaundice was present.
Investigation showed blood leucopenia with moderate to severe anemia and thrombocytopenia.
Chest X-ray was normal. ECG was normal and echocardiogram revealed small pericardial
effusion. Liver function test revealed moderate hypoalbuminemia with mild hyperbilirubinemia.
Dengue NS 1 antigen test was positive. His decreased consciousness level in spite of normal
hemodynamic stability prompted us to get a CT scan of brain without contrast followed by CSF
study.
CT scan of brain revealed acute extra axial subdural hemorrhage (SDH) with extra dural
hemorrhage (EDH) along right hemisphere with displacement of ventricle to the left. CSF study
was deferred due the presence of mass effect.
Conservative management was done with PRBC and platelet transfusions. As his sensorium
and mass effect improvement occurred in following 3 days, the motor paresis of the patient did
not significantly improve thereby prompting the neurosurgeon to perform surgical evacuation
of SDH plus EDH. The patient had an uneventful recovery.
References
- 1. World Health Organization. Dengue and severe dengue [Internet]. Geneva: World Health Organization; [date unknown] [cited 2026 Jan 20].
- 2. Kumar A, Mehta S, Singh P, Lal V. Dengue encephalitis: “Double doughnut” sign. Neurol India. 2017;65(3):670-671.
- 3. Singh M, Garg K, Bisht A, Sharma BS, Singh PK, Pandia M, et al. Spinal epidural hematoma with myelitis and brainstem hemorrhage: an unusual complication of dengue fever. Neurol India. 2013;61(5):541-543.
- 4. Agrawal A, Hegde KV, Reddy VU. The “CT Comma Sign” in concurrent extradural and hyperacute subdural hematomas is revisited. West Afr J Radiol. 2016;23(1):52-53.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
Whether all authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Choudhury K, Banerjee C, Biswas A. Dengue hemorrhagic fever presenting with intracranial extra-axial hemorrhage. Indian J Comm Dis. 2023;9(1):23-27.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| December 09, 2022 | January 05, 2023 | February 28, 2023 |
DOI: https://doi.org/10.21088/ijcd.2395.6631.9123.3
Keywords
Extra axial hemorrhageDengueHemorrhagicfeverCapillary leakageCraniectomySearch for Similar Articles
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Timeline
| Received | December 09, 2022 |
| Accepted | January 05, 2023 |
| Published | February 28, 2023 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
