Subarachnoid Hemorrhage during General Anesthesia for Vaginal Hysterectomy / 대한마취과학회지

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.