When to go to the ER if a hemophiliac has a head injury?

Question

Hello doctor,

My 16-year-old son with severe hemophilia A fell off a skateboard yesterday, and now complaining of a terrible headache and vomiting. I already gave Factor VIII at home, but the symptoms are getting worse. How do I know if he is bleeding inside his head? Last time, the ER kept us waiting for four hours because the staff did not understand his condition. His regular hematologist is out of town. Should I risk another ER visit? His factor levels were only 2 percent at the last check. Simply put, what is the danger here, and what should I tell emergency doctors so they take this seriously? He is scared, and I am terrified of making the wrong decision.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

If your son still has a headache, then go to the ER (emergency room). Did he hit his head?

Are there any swellings or vision problems? If so, then he needs emergency management.

Need a CT (computed tomography) brain and an MRI (magnetic resonance imaging) to look for a bleed. Intracranial bleeding can happen and cause a headache and vomiting.

The factors given will only prevent further bleeding, but can not remove the blood which accumulated from the accident. So, I need a complete evaluation. It is better to get his blood pressure, temperature, and give him transaminase, along with the factors. If the symptoms are relieved, then it is ok; otherwise, go to the emergency department. Sometimes, it is needed to remove the accumulated blood.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.