LIFE-THREATENING HEMORRHAGIC DIATHESIS DUE TO DISSEMINATED INTRAVASCULAR COAGULATION DURING ELECTIVE BRAIN-TUMOR SURGERY

Disseminated intravascular coagulation (DIC) is an extremely rare comp lication during elective brain tumor surgery. We report the case of a life-threatening intraoperative hemorrhagic diathesis due to a fulmina ting DIC during the removal of a grade III parietooccipital astrocytom a in a patient with a history of three pulmonary embolisms. Intraopera tively, 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 furt her blood component therapy. Laboratory data support the diagnosis of DIC: decreased fibrinogen and platelet count, prolonged thrombin and p rothrombin times, and the presence of fibrin monomers. With aggressive and swift treatment of the DIC, the patient survived with transient n eurological worsening.