title: Malignant brain stem hyperthermia caused by brain stem hemorrhage.
abstract: BACKGROUND
  We report two cases of brain stem hemorrhage characterized by severe hyperthermia, rhabdomyolysis, acute renal failure, and a rapidly fatal course.
  
  
  METHODS
  A 55-year-old man and a 65-year-old man were admitted with coma-producing brain stem hemorrhage accompanied by hyperthermia. Both underwent ventricular drainage.
  
  
  RESULTS
  Within 1 day of onset, both patients developed hyperthermia of over 41 degrees C, increased serum creatine phosphokinase (CPK) level indicating rhabdomyolysis, and acute renal failure. One patient died on the second day and the other on the third day after onset despite supportive treatment.
  
  
  CONCLUSIONS
  These cases of brain stem hemorrhage with fulminant hyperthermia should be distinguished from those with simple hyperthermia. They may represent a kind of malignant hyperthermia, in which case dantrolene sodium might be beneficial. Monitoring serum CPK levels would be of help in making the diagnosis early in the course.
authors.affiliation: Department of Neurosurgery, Tokyo University School of Medicine, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Kitanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Inoh
authors.forename: T
authors.initials: T
authors.lastname: Toyoda
authors.forename: T
authors.initials: T
authors.lastname: Sasaki
authors.forename: T
authors.initials: T
authors.lastname: Eguchi
mesh_terms: D000368:Aged; D001933:Brain Stem / Q000000981:diagnostic imaging*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging*; D003128:Coma; D006801:Humans; D008297:Male; D008305:Malignant Hyperthermia / Q000209:etiology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed