Life-threatening hemorrhagic diathesis due to disseminated intravascular coagulation during elective brain tumor surgery.
Disseminated intravascular coagulation (DIC) is an extremely rare complication during elective brain tumor surgery. We report the case of a life-threatening intraoperative hemorrhagic diathesis due to a fulminating DIC during the removal of a grade III parietooccipital astrocytoma in a patient with a history of three pulmonary embolisms. Intraoperatively, the patient required 13 U of blood, 9 U of fresh-frozen plasma, and 5.45 L of colloids and crystalloids (total volume infused during the procedure: 12.5 L). Bleeding persisted for 24 h and required further blood component therapy. Laboratory data support the diagnosis of DIC: decreased fibrinogen and platelet count, prolonged thrombin and prothrombin times, and the presence of fibrin monomers. With aggressive and swift treatment of the DIC, the patient survived with transient neurological worsening.
Berger
M M
MM
Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Ravussin
P
P
Vielle
G
G
Fankhauser
H
H
D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001932:Brain Neoplasms / Q000601:surgery*; D003102:Colloids / Q000627:therapeutic use; D000077324:Crystalloid Solutions; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D017558:Elective Surgical Procedures; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D007552:Isotonic Solutions; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000627:therapeutic use; D015532:Rehydration Solutions / Q000627:therapeutic use
D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D015532:Rehydration Solutions