Korean J Anesthesiol.  2016 Oct;69(5):527-531. 10.4097/kjae.2016.69.5.527.

Intracranial hemorrhage induced uncontrolled seizure in a deceased donor liver transplant patient: a case report

Affiliations
  • 1Department of Surgery, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea. hogeol@gmail.com

Abstract

Seizure is the second most common neurologic complication after liver transplantation and may be caused by metabolic abnormalities, electrolyte imbalance, infection, and immunosuppressant toxicity. A 61-year-old male patient underwent liver transplantation due to hepatitis B virus-related liver cirrhosis with portal systemic encephalopathy. The immediate postoperative course of the patient was uncomplicated. However, on postoperative day (POD) 6, weakness developed in both lower extremities. No abnormal findings were detected on a brain computed tomography (CT) scan on POD 8, but a generalized tonic clonic seizure developed which was difficult to control even with multiple antiepileptic drugs. A follow-up brain CT scan on POD 15 showed a 2.7 cm sized acute intracranial hemorrhage (ICH) in the left parietal lobe. The patient's mental status improved after 2 months and he was able to communicate through eye blinking or head shaking. Our case reports an acute ICH that manifested into a refractory seizure in a patient who underwent a liver transplant.

Keyword

Encephalopathy; Intracranial hemorrhages; Liver transplantation; Seizures

MeSH Terms

Anticonvulsants
Blinking
Brain
Brain Diseases
Follow-Up Studies
Head
Hepatic Encephalopathy
Hepatitis B
Humans
Intracranial Hemorrhages*
Liver Cirrhosis
Liver Transplantation
Liver*
Lower Extremity
Male
Middle Aged
Parietal Lobe
Seizures*
Tissue Donors*
Tomography, X-Ray Computed
Anticonvulsants

Cited by  1 articles

Careful neurologic examination and treatment for intracranial hemorrhage after liver transplantation in patients with alcoholic cirrhosis: case reports
Byeonggwan Noh, Nuri Lee, Jae Il Lee, Myunghee Yoon
Korean J Transplant. 2021;35(4):275-280.    doi: 10.4285/kjt.21.0021.

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