Korean J Anesthesiol.  1998 Aug;35(2):391-394. 10.4097/kjae.1998.35.2.391.

Spontaneous Intracranial Hemorrhage Occurring during General Anesthesia in a Patient with Metastatic Brain Tumor: A case report

• Ahn SW
• Kim TH

• KMID: 2298961
• DOI: http://doi.org/10.4097/kjae.1998.35.2.391

Abstract

Spontaneous intracranial hemorrhage (ICH) occurs rarely during general anesthesia. We report a case of metastatic brain tumor producing an ICH during general anesthesia. A 47-year-old man was scheduled for the wedge resection of left lower lobe of lung under general anesthesia. He did not show any abnormal neurological sign and coagulation abnormality on arrival in the operating room. But he had a history of right hemiplegia 9 months ago which resolved completely. He was anesthetized for about 2 hours. Until 1 hour after the end of anesthesia and operation he did not regain his consciousness, but responded well to external stimuli. He was expected to be better, but his mentality became worse. Immediate computerized tomogram of brain revealed a left ICH. An emergency craniectomy was performed to remove the hematoma. Pathological investigations demonstrated a metastatic brain tumor from liver cell carcinoma. We presume that this intratumoral bleeding was produced by high intracranial blood pressure relating to general anesthesia or obstruction of jugular venous drainage by abnormal positioning of head.

Keyword

Anesthesia: general; Brain: tumor; Hemorrhage: intracranial

MeSH Terms

Anesthesia
Anesthesia, General*
Blood Pressure
Brain Neoplasms*
Brain*
Carcinoma, Hepatocellular
Consciousness
Drainage
Emergencies
Head
Hematoma
Hemiplegia
Hemorrhage
Humans
Intracranial Hemorrhages*
Lung
Middle Aged
Operating Rooms