Acute cerebral infarction caused by severe anaphylactic shock: A case report

Perioperative anaphylactic reactions, especially those induced by colloid solutions like gelatins, can lead to severe hypotension and tissue hypoperfusion, with potential serious complications. We present a rare case of acute cerebral infarction following severe anaphylaxis during sinus lesion resection under general anesthesia. A 16-year-old patient received succinylated gelatin for hypovolemia. Within 7 min, the patient developed profound hypotension (45/25 mmHg), tachycardia (139 bpm), and severe desaturation (63%), necessitating treatment with epinephrine and 35 min of continuous resuscitation Postoperatively, the patient developed headache and memory deficits, prompting an MRI that revealed an acute infarction. Follow-up MRI on postoperative day 27 showed significant lesion resolution accompanied by improvement in neurological symptoms. This case highlights cerebral ischemia as a potential sequela of anaphylaxis-induced hypotension, emphasizing prompt hemodynamic stabilization and neurologic vigilance in perioperative hypersensitivity reactions.