Intracerebral hemorrhage following enucleation: a result of surgery or anesthesia?--A case report.
Choroidal melanoma is the most common primary intraocular cancer in adults. A sixty-nine years old, hypertensive male with a choroidal melanoma underwent enucleation. After extubation he woke up confused and unconscious. An emergent computed tomographic (CT) scan demonstrated intracerebral hematoma. The underwent repeat surgery in the postoperative first hour, because of left parietotemporal intracerebral hematoma. His neurological state became worse and he died in the eighth postoperative day. Sympathetic stimulation due to extubation, causing increase in the intracranial pressure or uncontrolled hypertension, may be reasons precipitating intracranial hemorrhage. In patients, who undergo intracranial or intraorbital surgery, had risk factors of intracranial hemorrhage or showed labile blood pressure perioperatively and were confused or unconscious in the postoperatively or had delayed emergence, intracranial hematoma must be suspected.
Dal
Didem
D
Department of Anaesthesiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. didemdal@yahoo.com
Erden
Aydin
A
Saricaoğlu
Fatma
F
Aypar
Ulku
U
D000368:Aged; D000758:Anesthesia / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000150:complications; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002830:Choroid Neoplasms / Q000150:complications / Q000601:surgery*; D003221:Confusion / Q000209:etiology; D015353:Eye Enucleation / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000150:complications; D020198:Intracranial Hemorrhage, Traumatic / Q000209:etiology / Q000601:surgery; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008545:Melanoma / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D014057:Tomography, X-Ray Computed