Korean J Anesthesiol.  1990 Dec;23(6):1050-1054. 10.4097/kjae.1990.23.6.1050.

Subarachnoid Hemorrhage during General Anesthesia for Vaginal Hysterectomy

• Shim JM
• Kim KS
• Kang WJ
• Lee DI
• Shin KI

• KMID: 2237165
• DOI: http://doi.org/10.4097/kjae.1990.23.6.1050

Abstract

Intracranial hemorrhage is one of the fatal complications related to general anesthesia, it can occur in patients with intracranial aneurysm, hypertension, vascular malformation, malignancy and blood dyscrasia. We have experienced a case of death from massive surbarachonoid hemorrhage during general anesthesia. A 38 Years old female patient who had no abnormality in past history, physical examination and laboratory finding preoperatively, admitted for vaginal hysterectomy becauae of secondary uterine prolapse. Anesthesia was performed under tracheal intubation with Halothane-Enflurane, O2,N2O and with induction by pentothal sodium and succinylcholine. After operation, the patient showed delayed recovery from anesthesia and both pupils were dilated without light reflex. In optic fundoscopic view, fundus was furfilled with red-pinkish blood and CSF in spinal tapping was dark bloody colored. Brain C-T showed generalized brain edema and hemorrhage density in sylvian cistern, basal cistern, lateral ventricle. Autopsy finding revealed massive subarachnoidal hemorrhage but not disclosed the site of ruptured intracranial aneurysm. Authors report this case of death from subarachnoid hemorrhage for warning of possible victim during general anesthesia for referencial review.

Keyword

General anesthesia; Intracranial aneurysm; Subarachnoid hemorrhage

MeSH Terms

Adult
Anesthesia
Anesthesia, General*
Autopsy
Brain
Brain Edema
Delayed Emergence from Anesthesia
Female
Hemorrhage
Humans
Hypertension
Hysterectomy, Vaginal*
Intracranial Aneurysm
Intracranial Hemorrhages
Intubation
Lateral Ventricles
Physical Examination
Pupil
Reflex
Sodium
Spinal Puncture
Subarachnoid Hemorrhage*
Succinylcholine
Thiopental
Uterine Prolapse
Vascular Malformations
Sodium
Succinylcholine
Thiopental