Work

Fatal warfarin-associated intracranial hemorrhage with intraventricular extension in a child with mechanical mitral valve presenting as persistent headache initially treated as acute sinusitis: a case report

Year: 2026

Type: article

Abstract: Warfarin therapy in pediatric patients with mechanical heart valves carries a risk of life-threatening bleeding complications. We report a fatal case of warfarin-associated intracranial hemorrhage in a 7-year-old female with mechanical mitral valve replacement who presented with persistent headache initially treated as acute bacterial sinusitis. Her international normalized ratio rose from 2.60 measured 2 months earlier to 5.03. Computed tomography demonstrated a left parieto-occipital intraparenchymal hematoma with extension to all ventricles. Despite intensive treatment, she died. This case illustrates that persistent headache in anticoagulated pediatric patients should prompt early neuroimaging even when the initial neurological examination shows benign findings. For prevention of such fatal outcomes, it is essential to monitor international normalized ratio every 2–4 weeks.

Source: Pediatric Emergency Medicine Journal

DOI: 10.22470/pemj.2026.01648

Authors: Çağdaş Derdiyok, Durmuş Gençer

Language: English

Topic: Intracerebral and Subarachnoid Hemorrhage Research

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $200

OpenAlex ID: W7161586709