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Stroke, Vol 25, 508-510, Copyright © 1994 by American Heart Association

ARTICLES

Congenital deficiency of factor VII in subarachnoid hemorrhage

ML Papa, G Schisano, A Franco and P Nina
Department of Haematology, Ospedale Nuovo Pellegrini, Naples, Italy.

BACKGROUND: Factor VII is essential for coagulation activation by the extrinsic pathway. Hemorrhages of the central nervous system in patients with congenital factor VII deficiency seem to have a higher incidence compared with other congenital coagulopathies. The purpose of this paper is to report two rare cases of subarachnoid hemorrhage and factor VII deficiency. CASE DESCRIPTION: Two cases of women affected by a congenital deficiency of factor VII and subarachnoid hemorrhage are reported. Diagnosis was obtained by cerebral computer tomography; cerebral pan-angiography was normal. Complete coagulation studies were performed showing prothrombin time prolongation and factor VII deficiency. In one patient, family studies revealed the existence of a similar coagulation disorder. CONCLUSIONS: We suggest routine coagulation studies in all patients with subarachnoid hemorrhage. Determination of factor VII activity might be performed in patients with normal activated partial thromboplastin time and prolonged prothrombin time.

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