Spontaneous intracerebral hemorrhage during left hemihepatectomy in a cirrhotic patient

Spontaneous intracerebral hemorrhage (sICH) is bleeding that occurs without trauma or known structural abnormality. Hypertension is a main cause of sICH, but liver cirrhosis may be another reason; however, this rarely occurs under anesthesia. We report on a case of sICH in a 75-year-old woman patient with liver cirrhosis during left hemihepatectomy. And the literature on the usefulness of perioperative bispectral index monitoring for early detection of brain damage is reviewed.