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[Intracranial hematoma secondary to chronic DIC (author's transl)].

Five cases of intracranial hematoma secondary to chronic disseminated intravascular coagulation syndrome (DIC) were reported. Intracranial hematomas included a case of acute subdural hematoma combined with intracerebral hematoma and 4 cases of acute or subacute hematoma. Primary diseases which caused DIC were cancer; a case of carcinoma of choledochus and 4 cases of gastric carcinoma. All cases were in the advanced stage of carcinoma or at least, had metastasis to other organs. They showed coagulation disorders, such as, the reduction of platelets and the hemorrhagic diastasis, which were referred as chronic DIC, before the onset of intracranial hematoma. After the onset of intracranial hematoma, their coagulation disorders got worse and were diagnosed as acute DIC. They showed the rising of FDP, reduction of the serum fibrinogen and platelets and others. The blood transfusion and the trivial head injury were considered a triggers of exacervation from chronic DIC to acute DIC, that is, from compensated DIC to decompensated DIC. The long-term administration of anticancer drugs might play a part of the role as triggers. Initial symptoms of intracranial hematoma were headache in 4 case and dullness in a case. Three cases immediately lapsed into coma after 1 to 2 hours from the onset. Two cases turned out coma state after 4 to 5 days from the onset. Evacuations of hematoma were performed in 3 cases but they gave rise to rebleeding of intracranial hematomas later. All of 5 cases including surgically and non-surgically treated cases died at last. It is certain that DIC is rather common in the advanced stage of cancer. Matsuda reported that DIC existed in 20% of died patients with cancer. Though the incidence of intracranial hematoma secondary to DIC were less than that of cerebral infarct, it is no reasonable to assume that the actual number of the intracranial hematoma secondary to chronic DIC is rare.