Acute Leukemia and Severe Thrombocytopenia in Neurosurgical Patient: A Case Report

Severe thrombocytopenia (less than 50,000 platelets count per microliter with the normal range of 150,000 to 450,000 per microliter) can complicate the management of neurosurgical patients by significantly increasing the potential risk of bleeding during or after invasive procedures. Even though the current standard-of-care treatment for severe thrombocytopenia is platelet transfusion, the optimal platelet count for safe neurosurgical procedure is still controversial. We report a case of a 57-year-old woman, newly diagnosed with acute leukemia, and followed up in the clinical hematology department that is a candidate for external ventricular shunt (EVS) for acute hydrocephalus revealed by intracranial hypertension and drowsiness. Severe thrombocytopenia was found in her laboratory result of blood analysis. She had been reoperated the same day for acute subdural hematoma as a complication of the drainage. The patient died of septic shock in the ICU two weeks later.