Background We report two cases of brain stem hemorrhage characterized
by severe hyperthermia, rhabdomyolysis, acute renal failure, and a rap
idly fatal course. Methods A 55-year-old man and a 65-year-old man wer
e admitted with coma-producing brain stem hemorrhage accompanied by hy
perthermia. Both underwent ventricular drainage. Results Within 1 day
of onset, both patients developed hyperthermia of over 41 degrees C, i
ncreased serum creatine phosphokinase (CPK) level indicating rhabdomyo
lysis, 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 hypert
hermia should be distinguished from those with simple hyperthermia. Th
ey may represent a kind of malignant hyperthermia, in which case dantr
olene sodium might be beneficial. Monitoring serum CPK levels would be
of help in making the diagnosis early in the course.