Superficial siderosis presenting as hemiparesis in a paediatric patient with congenital Factor V deficiency – A case report.

Abstract

Superficial siderosis is a rare abnormality caused by deposition of hemosiderin in the subpial or subarachnoid spaces of the brain, cranial nerves, and spinal cord. It results from chronic repetitive bleeding in the subpial/subarachnoid space. Magnetic resonance imaging of the brain is the diagnostic modality of choice. We describe a rare case of an 18-month-old male, a known case of congenital Factor V deficiency, who presented with recurrent vomiting, irritability and right-sided hemiparesis. On Magnetic resonance imaging, there was hypointense coating of the surface of the brainstem and cerebellum with ventricular dilatation. This case emphasizes the fact that superficial siderosis should be specifically looked for when evaluating a patient with a history of previous intracranial bleed followed by a thorough search for the source of the hemorrhage.