Case Report: Extensive Subarachnoid Hemorrhage Secondary To Surgical Resection In Castleman Disease

Background: Castleman disease (CD) is a rare lymphoproliferative disease with main clinical manifestation of painless lymphadenopathy. The pathogenesis is not clear. There was a few correlation between CD and nervous system diseases. So far, extensive subarachnoid hemorrhage (SAH) secondary to surgical resection in CD has not been reported. Case presentation: We presented a 24-year-old woman who suffered from anemia 3 years ago, and failed to find the cause of anemia with repeated bone punctures. The anemia was corrected after surgical resection of abdominal mass, the pathological diagnosis of which was consistent with the plasma cell type of CD. However, the patient had a severe headache on the fourth day after operation, and cranial computed tomography (CT) showed extensive subarachnoid hemorrhage, while CT angiography (CTA) and digital subtraction angiography (DSA) were normal. After three weeks treatment, hemorrhage in brain was absorbed completely. She recovered and had no recurrence during our 4-year follow-up. Conclusions: : Extensive SAH could occur in CD after surgical resection. The methods of intervening the rapidly increased number of intravascular red blood cells after surgical excision might reduce the occurrence of SAH in CD.