Intracranial hemorrhage induced uncontrolled seizure in a deceased donor liver transplant patient: a case report.
10.4097/kjae.2016.69.5.527
- Author:
Seung Young OH
1
;
Hannah LEE
;
Yang Hyo PARK
;
Ho Geol RYU
Author Information
1. Department of Surgery, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Encephalopathy;
Intracranial hemorrhages;
Liver transplantation;
Seizures
- MeSH:
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
- From:Korean Journal of Anesthesiology
2016;69(5):527-531
- CountryRepublic of Korea
- Language:English
-
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.
