RESUMO
Conventional treatment of two patients with chronic idiopathic thrombocytopenic purpura (CITP) and petechial intracranial hemorrhage was ineffectual. However, after a treatment with vincristine, the neurological manifestations disappeared and platelet counts improved; clinical recovery was complete. This success contrast with results informed in similar patients treated with corticosteroids or splenectomy, among whom the mortality is as high as 100%. The favorable reaction may be related to the various mechanisms of the action of vincristine, which usually lead to control of CITP. The use of this drug is proposed in association of conventional therapy of this severe complication, especially in patients in whom splenectomy is contraindicated.