Postoperative cerebral bleeding in a boy with suspected mild deficiency of fibrinogen and FXIII

•Analysis with rotational thromboelastometry confirmed bleeding tendency.•The in vitro study showed impaired clot stability to proteolysis at plasma dilution.•The clot stability improved after addition of fibrinogen concentrate and tranexamic acid.•Hyper-proteolytic potential of fibrin clot may explain the bleeding tendency.