title: Distributive shock, cardiac arrhythmias and multiple organ failure following surgery of a fourth ventricular epidermoid.
abstract: A 33-years-old male patient presented with cardiac arrhythmias, acute shock and multiple organ dysfunction after the surgical removal of a massive epidermoid posterior to the brainstem. The patient initially presented with paraesthesia along the right C6 dermatome due to a big tumour at the brain stem. Surgical removal was performed without adverse events and he was transferred to our intensive care unit (ICU) immediately after the operation. Though initially showing a stable postsurgical course he developed cardiac arrhythmias and a state of acute distributive shock with consecutive multi organ failure. Extensive diagnostic measures could not identify a specific cause for this rapid deterioration. However, under carefully monitored symptomatic therapy the patient improved quickly, was extubated 72 h after admission and discharged from the ICU 6 days later. The follow-up did not show any persisting neurological deficits and no evidence of a residual tumour in the MRI-study.
authors.affiliation: Department of Anesthesia and Intensive Care, University of Leipzig, Medical Faculty, Leipzig, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Bercker
authors.affiliation: Department of Neurosurgery, University of Leipzig, Medical Faculty, Leipzig, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Meixensberger
authors.affiliation: Department of Anesthesia and Intensive Care, University of Leipzig, Medical Faculty, Leipzig, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Laudi
authors.affiliation: Department of Neurosurgery, University of Leipzig, Medical Faculty, Leipzig, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Renner
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D020295:Brain Stem Neoplasms / Q000150:complications / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D012769:Shock / Q000209:etiology*; D016896:Treatment Outcome