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Idiopathic thrombocytopenic purpura and intracranial hemorrhage.

In this issue of Pediatrics (p 453) Drs Woerner, Abildgaard, and French present three new cases of intracranial hemorrhage in children with idiopathic thrombocytopenic purpura (ITP) and review the data of 15 previously reported cases. The authors discuss the care and management of this most severe complication of an otherwise mainly benign disorder and emphasize that, although it occurs most commonly in the early days after diagnosis, intracranial hemorrhage can occur in patients with ITP at nearly any time after onset. Their review and personal experience indicate that, even if CNS symptoms are already present, the alert physician with the present armamentarium of computed tomography (CT) scan, platelet transfusion, and splenectomy should be able to prevent permanent Sequelae in the majority of patients treated in an effective manner.