Kitanaka C, Inoh Y, Toyoda T, Sasaki T, Eguchi T
Department of Neurosurgery, Tokyo University School of Medicine, Japan.
Stroke. 1994 Feb;25(2):518-20. doi: 10.1161/01.str.25.2.518.
We report two cases of brain stem hemorrhage characterized by severe hyperthermia, rhabdomyolysis, acute renal failure, and a rapidly fatal course.
A 55-year-old man and a 65-year-old man were admitted with coma-producing brain stem hemorrhage accompanied by hyperthermia. Both underwent ventricular drainage.
Within 1 day of onset, both patients developed hyperthermia of over 41 degrees C, increased serum creatine phosphokinase (CPK) level indicating rhabdomyolysis, and acute renal failure. One patient died on the second day and the other on the third day after onset despite supportive treatment.
These cases of brain stem hemorrhage with fulminant hyperthermia should be distinguished from those with simple hyperthermia. They may represent a kind of malignant hyperthermia, in which case dantrolene sodium might be beneficial. Monitoring serum CPK levels would be of help in making the diagnosis early in the course.
我们报告两例以严重高热、横纹肌溶解、急性肾衰竭和快速致命病程为特征的脑干出血病例。
一名55岁男性和一名65岁男性因导致昏迷的脑干出血伴高热入院。两人均接受了脑室引流。
发病1天内，两名患者均出现体温超过41摄氏度的高热、血清肌酸磷酸激酶（CPK）水平升高提示横纹肌溶解以及急性肾衰竭。尽管进行了支持治疗，但一名患者在发病后第二天死亡，另一名在第三天死亡。
这些伴有暴发性高热的脑干出血病例应与单纯高热的病例相鉴别。它们可能代表一种恶性高热，在这种情况下，丹曲林钠可能有益。监测血清CPK水平将有助于在病程早期做出诊断。
