MALIGNANT BRAIN-STEM HYPERTHERMIA CAUSED BY BRAIN-STEM HEMORRHAGE

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.