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Spontaneous and recurrent subdural haematoma in a patient with May-Hegglin anomaly
  1. John Anthony Doherty1,
  2. Christopher Paul Millward1,2 and
  3. Zaid Sarsam1
  1. 1Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
  2. 2Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, UK
  1. Correspondence to Christopher Paul Millward; drcpm{at}liverpool.ac.uk

Abstract

Both acute and chronic subdural haematomas typically occur following trauma. Non-traumatic causes are less common, but aetiologies include arteriovenous malformation, intracranial aneurysm rupture, tumour-associated haemorrhage and coagulopathies. May-Hegglin anomaly is an example of a coagulopathy, which is caused by a mutation in the gene encoding non-muscle myosin heavy chain 9 (MYH9) and therefore falls into a group of diseases referred to as MYH9-related diseases (MYH9-RD). The symptomology of MYH9-RD is often mild, and patients tend to experience epistaxis, gingival bleeding and bruising. Life-threatening haemorrhage rarely occurs. In this short report, we describe a patient with known May-Hegglin anomaly who presented with a potentially life-threatening, spontaneous subdural haematoma requiring surgery on two occasions. This is only the second such report in the literature, and the first of spontaneous and recurrent haemorrhage in association with May-Hegglin anomaly.

  • haematology (incl blood transfusion)
  • neurosurgery

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Footnotes

  • Twitter @CM_Neurosurgeon

  • Contributors CPM conceived the report, JAD and CPM drafted the report and figures, JAD, CPM and ZS critically reviewed the final draft of the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.