A 38 month old boy with excessive bleeding following circumcision as a newborn and two episodes of intracranial hemorrhage at four months and at 85 months of age is reported from the Scott and White Clinic, Temple, TX. The diagnosis of Factor XIII deficiency was made in infancy and the bleeding was stopped with months of age is reportedcryoprecipitate. Since 11 months of age he was treated with Fibrogammin at four week intervals and no further hemorrhages had occurred. MRI at three years demonstrated a left temporoparietal encephalomalacia and no vascular malformations. [1]

COMMENT. Repeated intracranial hemorrhage can occur spontaneously and without evidence of trauma in infants with Factor XIII deficiency. Routine coagulation studies do not detect this factor deficiency and examination for Factor XIII may avoid a misdiagnosis of child abuse. Replacement therapy should be maintained throughout life.