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- Bilateral thalamic haemorrhages
- alcohol-induced thrombocytopenia
- traumatic brain injury
- subdural haematoma
- alcoholism, forensic pathology
Bilateral thalamic haemorrhage (TH) is rare and known to be related to hypertension,1 venous thrombosis2 or intravenous administration of tissue plasminogen activator.3 In 1968, Lindenbaum and Hargrove reported the first series of alcohol-induced thrombocytopenia (AIT)4 and confirmed causality to intravenous ethanol administration.5 This type of thrombocytopenia was reversed within 5–20 days of abstinence.6 Previously, it has been shown that in 112 alcoholic patients, of whom 32% experienced thrombocytopenia, none of the patients had liver disease or haematopoietic abnormalities.7 This study is the first report of bilateral TH related to trauma or AIT and the first autopsy report on death associated with AIT.
A middle‐aged man with a 15-year history of idiopathic thrombocytopenic purpura was referred to one of us (KO) 2 years ago. He presented with thrombocytopenia, without changes in the bone marrow except for a mild megakaryocytosis. He was a heavy drinker. His platelet count surpassed 10 000/μl only during abstinence for 5 days or more: once during hospitalisation for bipolar hip arthroplasty of the femoral head, 4 months ago. The temporal correlation between binge drinking and thrombocytopenia supported the diagnosis of AIT.
On one occasion, on his way home …
Competing interests None.
Patient consent Obtained.
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