Toshiyuki Hikita^1）, Hirokazu Kutuma^1）, Yuko Osaka^1，3）, Natsue Nakamoto^1）,
Sono Kaneko^1）, Yasushi Fujii^1）, Yasuko Fujita^1）, Shigetoshi Kobayashi^1）, Takuya Hattori^1）, Hiroshi Oba^2）, Yukishige Yanagawa^1）

Department of Pediatrics^1）and Radiology^2）, Teikyo University School of Medicine
Department of Pediatrics, Tokyo University School of Medicine^3）

　　Intracranial hemorrhage is a rare but life threatening complication of childhood idiopathic thrombocytopenic purpura (ITP). The purpose of this report is to describe a case of ITP with multiple areas of intracranial hemorrhage in a 14-year-old Korean-Japanese girl.
　　The patient was admitted to the hospital following a sudden episode of diminished consciousness. She had a history of vomiting for one day and purpura for 18 days. On physical examination, she was confused and drowsy. Hematological examination revealed a hemoglobin of 7.4 g/dl and platelet count of 1000/μl. Computed tomography (CT) revealed multiple intracranial hemorrhages in the white matter. Initially, the patient was given 10 units of platelets, 1 g/kg of gamma globulin and 1 g of methylprednisolone intravenously, and received a second transfusion of platelets, gamma globulin and methylprednisolone the following day. Her level of consciousness rapidly progressed to normal. Her platelet count continually improved, and a tapered regiment of oral predonisolone was started at 60 mg/day. A magnetic resonance imaging (MRI) performed 15 days later showed some residual hemorrhage. A CT scan performed 5 months later showed calcification in the area of the hemorrhage.

Keywords：Idiopathic thrombocytopenic purpura (ITP), multiple intracranial hemorrhage (multiple ICH), Computed tomography (CT), Magnetic resonance imaging (MRI)