Multiple cerebral infarction during anesthesia in a patient with hypergammaglobulinemia

: We experienced anesthetic management of two patients with hypergammaglobulinemia undergoing thoracoscopic lung biopsy, one of whom suffered from multiple cerebral infarction during anesthesia. Pathogenesis of this serious complication could not be elucidated. However, decrease in cerebral regional circulation caused by increase in blood viscosity would be most probable. We should preoperatively carry out measurement of blood viscosity and brain CT scan, and consider plasma exchange in patient with hypergammaglobulinemia, in whom symptoms and signs of hyperviscosity syndrome do not exist.